Background: Functional electrical stimulation (FES) therapy has been shown to be one of the most promising approaches for improving voluntary grasping function in individuals with subacute cervical spinal cord injury (SCI). Objective: To determine the effectiveness of FES therapy, as compared to conventional occupational therapy (COT), in improving voluntary hand function in individuals with chronic (ε24 months post injury), incomplete (American Spinal Injury Association Impairment Scale [AIS] B-D), C4 to C7 SCI. Methods: Eight participants were randomized to the intervention group (FES therapy; n = 5) or the control group (COT; n = 3). Both groups received 39 hours of therapy over 13 to 16 weeks. The primary outcome measure was the Toronto Rehabilitation Institute–Hand Function Test (TRI-HFT), and the secondary outcome measures were Graded Redefined Assessment of Strength Sensibility and Prehension (GRASSP), Functional Independence Measure (FIM) self-care subscore, and Spinal Cord Independence Measure (SCIM) self-care subscore. Outcome assessments were performed at baseline, after 39 sessions of therapy, and at 6 months following the baseline assessment. Results: After 39 sessions of therapy, the intervention group improved by 5.8 points on the TRI-HFT’s Object Manipulation Task, whereas the control group changed by only 1.17 points. Similarly, after 39 sessions of therapy, the intervention group improved by 4.6 points on the FIM self-care subscore, whereas the control group did not change at all. Conclusion: The results of the pilot data justify a clinical trial to compare FES therapy and COT alone to improve voluntary hand function in individuals with chronic incomplete tetraplegia.
Popovic MR, Thrasher TA, Adams ME, Takes V, Zivanovic V, Tonack MI. Functional electrical therapy: Retraining grasping in spinal cord injury. Spinal Cord. 2006;44(3):143–151.
,
Functional electrical therapy: Retraining grasping in spinal cord injury
, Spinal Cord.
, vol. 44
(pg. 143
-151
) Popovic MR, Kapadia N, Zivanovic V, Furlan JC, Craven BC, McGillivray C. Functional electrical stimulation therapy of voluntary grasping versus only conventional rehabilitation for patients with subacute incomplete tetraplegia: A randomized clinical trial. Neurorehabil Neural Repair. 2011;25(5):433–443.
,
Functional electrical stimulation therapy of voluntary grasping versus only conventional rehabilitation for patients with subacute incomplete tetraplegia: A randomized clinical trial
, Neurorehabil Neural Repair.
, vol. 25
(pg. 433
-443
) Kapadia N, Zivanovic V, Furlan J, Craven BC, McGillivray C, Popovic MR. Functional electrical stimulation therapy for grasping in traumatic incomplete spinal cord injury: Randomized control trial. Artificial Organs. 2011;35(3):212–216.
,
Functional electrical stimulation therapy for grasping in traumatic incomplete spinal cord injury: Randomized control trial
, Artificial Organs.
, vol. 35
(pg. 212
-216
) Popovic MR, Popovic DB, Keller T. Neuroprostheses for grasping. Neurol Res. 2002;24:443–452.
,
Neuroprostheses for grasping
, Neurol Res.
, vol. 24
(pg. 443
-452
) Anderson KD. Targeting recovery: Priorities of the spinal cord-injured population. J Neurotrauma. 2004;21(10):1371–1383.
,
Targeting recovery: Priorities of the spinal cord-injured population
, J Neurotrauma.
, vol. 21
(pg. 1371
-1383
) Peckham PH, Knutson JS. Functional electrical stimulation for neuromuscular application. Ann Rev Biomed Eng. 2005;7:327–360.
,
Functional electrical stimulation for neuromuscular application
, Ann Rev Biomed Eng.
, vol. 7
(pg. 327
-360
) Smith B, Peckham PH, Michael MW, Roscoe DD. An externally powered, multichannel, implantable stimulator for versatile control of paralyzed muscle. IEEE Trans Biomech Eng. 1987;44:781–790.
,
An externally powered, multichannel, implantable stimulator for versatile control of paralyzed muscle
, IEEE Trans Biomech Eng.
, vol. 44
(pg. 781
-790
) Popovic MR, Keller T. Modular transcutaneous functional electrical stimulation system. Med Eng Phys. 2005;27(1):81–92.
,
Modular transcutaneous functional electrical stimulation system
, Med Eng Phys.
, vol. 27
(pg. 81
-92
) Popovic MR, Curt A, Keller T, Dietz V. Functional electrical stimulation for grasping and walking: Indications and limitations. Spinal Cord. 2001;39(8):403–412.
,
Functional electrical stimulation for grasping and walking: Indications and limitations
, Spinal Cord.
, vol. 39
(pg. 403
-412
) Popovic D, Stojanovic A, Pjanovic A, et al. Clinical evaluation of the bionic glove. Arch Phys Med Rehabil. 1999;80(3):299–304.
,
Clinical evaluation of the bionic glove
, Arch Phys Med Rehabil.
, vol. 80
(pg. 299
-304
) Gan LS, Prochazka A, Bornes TD, Denington AA, Chan KM. A new means of transcutaneous coupling for neural prostheses. IEEE Trans Biomed Eng. 2007;54(3):509–517.
,
A new means of transcutaneous coupling for neural prostheses
, IEEE Trans Biomed Eng.
, vol. 54
(pg. 509
-517
) Snoek GJ, IJzerman MJ, in ‘t Groen FA, Stoffers TS, Zilvold G. Use of the NESS Handmaster to restore handfunction in tetraplegia: Clinical experiences in ten patients. Spinal Cord. 2000;38:244–249.
,
Use of the NESS Handmaster to restore handfunction in tetraplegia: Clinical experiences in ten patients
, Spinal Cord.
, vol. 38
(pg. 244
-249
) Prochazka A, Gauthier M, Wieler M, Kenwell Z. The bionic glove: An electrical stimulator garment that provides controlled grasp and hand opening in quadriplegia. Arch Phys Med Rehabil. 1997;78(6):608–614.
,
The bionic glove: An electrical stimulator garment that provides controlled grasp and hand opening in quadriplegia
, Arch Phys Med Rehabil.
, vol. 78
(pg. 608
-614
) Mangold S, Keller T, Curt A, Dietz V. Transcutaneous functional electrical stimulation for grasping in subjects with cervical spinal cord injury. Spinal Cord. 2004;43(1):1–13.
,
Transcutaneous functional electrical stimulation for grasping in subjects with cervical spinal cord injury
, Spinal Cord.
, vol. 43
(pg. 1
-13
) Popovic MR, Thrasher TA, Zivanovic V, Takaki J, Hajek V. Neuroprosthesis for restoring reaching and grasping functions in severe hemiplegic patients. Neuromodulation. 2005;8(1):60–74.
,
Neuroprosthesis for restoring reaching and grasping functions in severe hemiplegic patients
, Neuromodulation.
, vol. 8
(pg. 60
-74
) Thrasher TA, Zivanovic V, McIlroy W, Popovic MR. Rehabilitation of reaching and grasping function in severe hemiplegic patients using functional electrical stimulation therapy. Neurorehabil Neural Repair. 2008;22(6):706–714.
,
Rehabilitation of reaching and grasping function in severe hemiplegic patients using functional electrical stimulation therapy
, Neurorehabil Neural Repair.
, vol. 22
(pg. 706
-714
) Knutson JS, Hisel TZ, Harley MY, Chae J. A novel functional electrical stimulation treatment for recovery of hand function in hemiplegia: 12-week pilot study. Neurorehabil Neural Repair. 2009;23(1):17–25.
,
A novel functional electrical stimulation treatment for recovery of hand function in hemiplegia: 12-week pilot study
, Neurorehabil Neural Repair.
, vol. 23
(pg. 17
-25
) Popovic DB, Sinkaer T, Popovic MB. Electrical stimulation as a means for achieving recovery of function in stroke patients. NeuroRehabilitation. 2009;25(1):45–58.
,
Electrical stimulation as a means for achieving recovery of function in stroke patients
, NeuroRehabilitation.
, vol. 25
(pg. 45
-58
) Hendricks HT, IJzerman MJ, de Kroon JR, in ‘t Groen FA, Zilvold G. Functional electrical stimulation by means of the “Ness Handmaster Orthosis” in chronic stroke patients: An exploratory study. Clin Rehabil. 2001;15(2):217–220.
,
Functional electrical stimulation by means of the “Ness Handmaster Orthosis” in chronic stroke patients: An exploratory study
, Clin Rehabil.
, vol. 15
(pg. 217
-220
) Chae J, Harley MY, Hisel TZ, et al. Intramuscular electrical stimulation for upper limb recovery in chronic hemiparesis: An exploratory randomized clinical trial. Neurorehabil Neural Repair. 2009;23(6):569–578.
,
Intramuscular electrical stimulation for upper limb recovery in chronic hemiparesis: An exploratory randomized clinical trial
, Neurorehabil Neural Repair.
, vol. 23
(pg. 569
-578
) Mangold S, Schuster C, Keller T, Zimmermann-Schlatter A, Ettlin T. Motor training of upper extremity with functional electrical stimulation in early stroke rehabilitation. Neurorehabil Neural Repair. 2009;23(2):184–190.
,
Motor training of upper extremity with functional electrical stimulation in early stroke rehabilitation
, Neurorehabil Neural Repair.
, vol. 23
(pg. 184
-190
) Popovic MB, Popovic DB, Sinkjaer T, Stefanovic A, Schwirtlich L. Restitution of reaching and grasping promoted by functional electrical therapy. Artific Organs. 2002;26(3):271–275.
,
Restitution of reaching and grasping promoted by functional electrical therapy
, Artific Organs.
, vol. 26
(pg. 271
-275
) Popovic MB, Popovic DB, Sinkjaer T, Stefanovic A, Schwirtlich L. Therapy of paretic arm in hemiplegic subjects augmented with a neural prosthesis: A cross-over study. Can J Physiol Pharmacol. 2004;82(8):749–756.
,
Therapy of paretic arm in hemiplegic subjects augmented with a neural prosthesis: A cross-over study
, Can J Physiol Pharmacol.
, vol. 82
(pg. 749
-756
) Kloosterman MG, Snoek GJ, Jannink MJ. Systemic review of the effects of exercise therapy on the upper extremity of patients with spinal cord injury. Spinal Cord. 2009;47(3):196–203.
,
Systemic review of the effects of exercise therapy on the upper extremity of patients with spinal cord injury
, Spinal Cord.
, vol. 47
(pg. 196
-203
) Needham-Shropshire BM, Broton JG, Cameron TL, Klose KJ. Improved motor function in tetraplegics following neuromuscular stimulation-assisted arm ergometry. J Spinal Cord Med. 1997;20(1):49–55.
,
Improved motor function in tetraplegics following neuromuscular stimulation-assisted arm ergometry
, vol. 20
(pg. 49
-55
) Kapadia N, Zivanovic V, Verrier M, Popovic MR. Toronto Rehabilitation Institute–Hand Function Test: Assessment of gross motor function in individuals with spinal cord injury. Top Spinal Cord Inj Rehabil. 2012;18(2):167–186.
,
Toronto Rehabilitation Institute–Hand Function Test: Assessment of gross motor function in individuals with spinal cord injury
, vol. 18
(pg. 167
-186
) Kalsi-Ryan S, Beaton D, McIlroy W, Fehlings M, Verrier M. Quantification of multimodality sensation of the hand in cervical spinal cord injury. J Spinal Cord Med. 2006;29(3):311.
,
Quantification of multimodality sensation of the hand in cervical spinal cord injury
, J Spinal Cord Med.
, vol. 29
pg. 311
Kalsi-Ryan S, Duff S, Rudhe C, Curt A, Fehlings M, Verrier M. Reliability and validity of the graded and redefined assessment of sensibility strength and prehension (GRASSP): A measure for hand impairment/function in tetraplegia. J Spinal Cord Med. 2008;31(2):226.
,
Reliability and validity of the graded and redefined assessment of sensibility strength and prehension (GRASSP): A measure for hand impairment/function in tetraplegia
, J Spinal Cord Med.
, vol. 31
pg. 226
Dodds TA, Martin DP, Stolov WC, Deyo RA. A validation of the functional independence measurement and its performance among rehabilitation inpatients. Arch Phys Med Rehabil. 1993;74:531–536.
,
A validation of the functional independence measurement and its performance among rehabilitation inpatients
, Arch Phys Med Rehabil.
, vol. 74
(pg. 531
-536
) Catz A, Itzkovich M, Agranov E, Ring H, Tamir A. SCIM – Spinal Cord Independence Measure: A new disability scale for patients with spinal cord lesions. Spinal Cord. 1997;35:850–856.
,
SCIM – Spinal Cord Independence Measure: A new disability scale for patients with spinal cord lesions
, Spinal Cord.
, vol. 35
(pg. 850
-856
) Beaumont E, Codina EG, Dubeau S, Lesage F, Nagai M, Popovic MR. Restoring locomotion after spinal cord injury by optimizing the afferent neuronal circuitry with functional electrical stimulation. J Spinal Cord Med. In press.
,
Restoring locomotion after spinal cord injury by optimizing the afferent neuronal circuitry with functional electrical stimulation. In press.
, J Spinal Cord Med.
Fawcett JW, Curt A, Steeves JD, et al. Guidelines for the conduct of clinical trials for spinal cord injury as developed by the ICCP panel: Spontaneous recovery after spinal cord injury and statistical power needed for therapeutic clinical trials. Spinal Cord. 2007; 45(3):190–205.
,
Guidelines for the conduct of clinical trials for spinal cord injury as developed by the ICCP panel: Spontaneous recovery after spinal cord injury and statistical power needed for therapeutic clinical trials
, Spinal Cord.
, vol. 45
(pg. 190
-205
)
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