A MOTOR REEDUCATION PROGRAM AIMED TO IMPROVE STRENGTH AND COORDINATION OF THE UPPER-LIMB OF A HEMIPARETIC SUBJECT

The objective of the study is to describe a new reeducation program ba sed on a multi-directional and multi-articular dynamometer and to eval uate its applicability in one chronic right hemiparetic subject. The t reatment sessions lasted 1 h and were conducted three times per week f or a period of 8 weeks. During these sessions, the subject was asked t o exert 10 repetitions of 16 torque combinations exerted at the should er, elbow and forearm or combined with handgrip exertion. The sequence of torques and force progressed from proximal to distal joints, and w ere realized in and out of the typical 'synergy patterns' described in this population. In addition, the levels of torque and force requeste d were increased progressively throughout the treatment period. The co ordination of both upper extremities, tested using the finger to nose test, and the dexterity of the affected side, evaluated using the Box and Blocks assessment, tended to improve as treatments progressed. The se results indicate the feasibility of this approach and suggest that it may be worthwhile examining the effectiveness of this approach on i mproving the functional performance of the upper extremity in a larger population of hemiparetic subjects. (C) 1997 Elsevier Science Ireland Ltd.