Deborah Backus1, Paul Cordo2, Amanda Gillott3, Casey Kandilakis4, Motomi Mori5, Ahmed M Raslan6. 1. Crawford Research Institute, Shepherd Center, Atlanta, GA. Electronic address: Deborah_backus@shepherd.org. 2. Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR; AMES Technology Inc, Portland, OR. 3. Post-Acute SCI Rehabilitation, Shepherd Center, Atlanta, GA. 4. Crawford Research Institute, Shepherd Center, Atlanta, GA. 5. Division of Biostatistics, Department of Public Health and Preventive Medicine, Oregon Health & Science University, Portland, OR. 6. Department of Neurological Surgery, Oregon Health & Science University, Portland, OR.
Abstract
OBJECTIVE: To test whether treatment with assisted movement with enhanced sensation (AMES) using vibration to the antagonist muscle would reduce impairments and restore upper limb function in people with incomplete tetraplegia. DESIGN: Prospective, pre-post study. SETTING: Laboratory and rehabilitation hospital. PARTICIPANTS: We recruited 15 arms from 10 individuals (8 men; mean age, 40.5 y; mean years postspinal cord injury [SCI], 3) with chronic, incomplete tetraplegia. INTERVENTION: Two or three 20-minute sessions per week over 9 to 13 weeks (25 sessions total) on the AMES device, which combines repeated movement with targeted vibration to the antagonist muscle. MAIN OUTCOME MEASURES: Strength and active motion tests on the AMES device; International Standards for the Neurological Classification of SCI (ISNCSCI) motor and sensory examinations; Modified Ashworth Scale (MAS); grasp and release test (GRT); Van Lieshout Test (VLT); and Capabilities of Upper Extremity questionnaire (CUE). RESULTS: The AMES strength test scores improved significantly in metacarpophalangeal flexion (P=.024) and extension (P=.007) and wrist flexion (P=.001) and extension (P<.000). The AMES active motion scores improved in the hand (P=.001) and wrist (P=.001). The MAS and ISNCSCI scores remained unchanged, whereas the GRT scores increased (P=.025). Post hoc analysis showed a trend from pre- to posttreatment (P=.068) and a significant change from pretreatment to 3-month follow-up (P=.046). There was no significant change in the VLT (P=.951) or the CUE (P=.164). Five of the 10 participants reported a return of sensation to the digits after the first, second, or third treatment session. CONCLUSIONS: People with chronic, incomplete tetraplegia may experience improvements in impairments and function after treatment on a device combining assisted movement and proprioceptive stimulation. Further investigation is warranted.
OBJECTIVE: To test whether treatment with assisted movement with enhanced sensation (AMES) using vibration to the antagonist muscle would reduce impairments and restore upper limb function in people with incomplete tetraplegia. DESIGN: Prospective, pre-post study. SETTING: Laboratory and rehabilitation hospital. PARTICIPANTS: We recruited 15 arms from 10 individuals (8 men; mean age, 40.5 y; mean years postspinal cord injury [SCI], 3) with chronic, incomplete tetraplegia. INTERVENTION: Two or three 20-minute sessions per week over 9 to 13 weeks (25 sessions total) on the AMES device, which combines repeated movement with targeted vibration to the antagonist muscle. MAIN OUTCOME MEASURES: Strength and active motion tests on the AMES device; International Standards for the Neurological Classification of SCI (ISNCSCI) motor and sensory examinations; Modified Ashworth Scale (MAS); grasp and release test (GRT); Van Lieshout Test (VLT); and Capabilities of Upper Extremity questionnaire (CUE). RESULTS: The AMES strength test scores improved significantly in metacarpophalangeal flexion (P=.024) and extension (P=.007) and wrist flexion (P=.001) and extension (P<.000). The AMES active motion scores improved in the hand (P=.001) and wrist (P=.001). The MAS and ISNCSCI scores remained unchanged, whereas the GRT scores increased (P=.025). Post hoc analysis showed a trend from pre- to posttreatment (P=.068) and a significant change from pretreatment to 3-month follow-up (P=.046). There was no significant change in the VLT (P=.951) or the CUE (P=.164). Five of the 10 participants reported a return of sensation to the digits after the first, second, or third treatment session. CONCLUSIONS:People with chronic, incomplete tetraplegia may experience improvements in impairments and function after treatment on a device combining assisted movement and proprioceptive stimulation. Further investigation is warranted.
Authors: Anastasia Shulga; Pantelis Lioumis; Aleksandra Zubareva; Nina Brandstack; Linda Kuusela; Erika Kirveskari; Sarianna Savolainen; Aarne Ylinen; Jyrki P Mäkelä Journal: Spinal Cord Ser Cases Date: 2016-07-14
Authors: Ronald A Bos; Claudia J W Haarman; Teun Stortelder; Kostas Nizamis; Just L Herder; Arno H A Stienen; Dick H Plettenburg Journal: J Neuroeng Rehabil Date: 2016-06-29 Impact factor: 4.262