Content » Vol 52, Issue 2

Original report

Efficacy of myoelectric bracing in moderately impaired stroke survivors: A randomized, controlled trial

Stephen Page, Christine Griffin, Susan White
Occupational Therapy Division, School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, USA. E-mail: spageneuro@gmail.com
DOI: 10.2340/16501977-2644

Abstract

Repetitive, task-specific practice increases functioning of the paretic upper extremity and decreases upper extremity motor impairment. One method to increase participation in repetitive, task-specific practice is an upper extremity myoelectric device, called the “Myomo”, which uses surface electromyography signals to assist with active movement of the moderately impaired hemiplegic upper extremity.
To determine the efficacy of regimens comprised of: () Myomo + repetitive, task-specific practice; () repetitive, task-specific practice only; and () Myomo only on outcomes for hemiplegic arm.
Using a randomized, controlled, single-blinded design, 34 subjects (20 males; mean age 55.8 years), exhibiting chronic, moderate, stable, post-stroke, upper extremity hemiparesis, were included. Participants were randomized to one of the above conditions, and administered treatment for 1 h/day on 3 days/week over an 8-week period. The primary outcome measure was the upper extremity section of the Fugl-Meyer Impairment Scale (FM); the secondary measurement was the Arm Motor Activity Test (AMAT).
The groups exhibited similar score increases of approximately +2 points, resulting in no differences in the amount of change on the FM (H= 0.376, = 0.83) and AMAT (H= 0.978 = 0.61).
The results suggest that a therapeutic approach integrating myoelectric bracing yields highly comparable outcomes to those derived from repetitive, task-specific practice-only. Myoelectric bracing could be used as alternative for labour-intensive upper extremity training due to its equivalent efficacy to hands-on manual therapy with moderately impaired stroke survivors.

Lay Abstract

After stroke, people often have difficulty moving one arm. This randomized controlled study examined a device that amplifies and helps muscle activity. Specifically, the study examined the effect of this device when it is provided as a component of conventional arm therapy, vs when it is provided by itself, or when conventional arm therapy is provided by itself. The study found that all 3 conditions render comparable benefits in terms of being able to move the arm again, and in terms of being able to use the arm for functional, valued, everyday tasks. This is an important finding; incorporation of the device alleviates some of the effort expended by the treating therapist and allows the patient to participate more actively in the therapy regimen. Therefore, this regimen could be used instead of a conventional regimen that relies solely on the therapist treating the client in a one-on-one fashion.

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