Thomas Schick1,2, Hans-Peter Schlake1, Juliane Kallusky3, Günter Hohlfeld4, Maria Steinmetz1, Florian Tripp5, Karsten Krakow5, Michaela Pinter6, Christian Dohle7,8. 1. Department of Neurology and Neurological Rehabilitation, Rehab Center Wilhelmshaven, Wilhelmshaven, Germany. 2. MED-EL Medical Electronics, Business Unit Neurorehabilitation STIWELL, Innsbruck, Austria. 3. Physiotherapist, Wilhelmshaven, Germany. 4. Department of Empirical Educational Research, FernUniversität in Hagen, Hagen, Germany. 5. Department of Neurology and Neurological Rehabilitation, Asklepios Neurological Hospital Falkenstein, Königstein/Taunus, Germany. 6. Department of Clinical Neurosciences and Preventive Medicine, Center for Neurorehabilitation, Danube University Krems, Krems, Austria. 7. MEDIAN Klinik Berlin-Kladow, Berlin, Germany. 8. Center for Stroke Research Berlin, Charité-University Medicine Berlin, Berlin, Germany.
Abstract
BACKGROUND: Neurorehabilitation requires the development of severity-dependent and successful therapies for arm/hand rehabilitation in stroke patients. OBJECTIVE: To evaluate the effectiveness of adding mirror therapy to bilateral EMG-triggered multi-channel electrostimulation for the treatment of severe arm/hand paresis in stroke patients. METHODS: The subjects of this randomized, controlled, multicentre study were stroke patients who had suffered their first insult between 1 and 6 months before study start and had severe or very severe arm/hand paresis, as classified by Fugl-Meyer-Assessment. Subjects were randomly allocated to an intervention group (n = 16) or control group (n = 17). Both groups were treated for 3 weeks (5x week, 30 minutes) with bilateral EMG-triggered multi-channel electrostimulation. The intervention group additionally received mirror feedback of the unaffected limb. The primary outcome measure was motor recovery of the upper extremities, as measured by the Fugl-Meyer Assessment. RESULTS: The Intervention Group with very severe paresis had significantly better motor recovery in total Fugl-Meyer Assessment (p = 0.017) at a medium effect size (Cohen) of d = 0.7, due to a significant recovery of shoulder and elbow function (p = 0.003) in the Fugl-Meyer Assessment Part A subtest. For subjects with severe paresis, additional mirror therapy did not significantly influence outcome. CONCLUSION: Additional mirror therapy in combination with EMG-triggered multi-channel electrostimulation is therapeutically beneficial for post-acute stroke patients with very severe arm/hand paresis.
RCT Entities:
BACKGROUND: Neurorehabilitation requires the development of severity-dependent and successful therapies for arm/hand rehabilitation in strokepatients. OBJECTIVE: To evaluate the effectiveness of adding mirror therapy to bilateral EMG-triggered multi-channel electrostimulation for the treatment of severe arm/hand paresis in strokepatients. METHODS: The subjects of this randomized, controlled, multicentre study were strokepatients who had suffered their first insult between 1 and 6 months before study start and had severe or very severe arm/hand paresis, as classified by Fugl-Meyer-Assessment. Subjects were randomly allocated to an intervention group (n = 16) or control group (n = 17). Both groups were treated for 3 weeks (5x week, 30 minutes) with bilateral EMG-triggered multi-channel electrostimulation. The intervention group additionally received mirror feedback of the unaffected limb. The primary outcome measure was motor recovery of the upper extremities, as measured by the Fugl-Meyer Assessment. RESULTS: The Intervention Group with very severe paresis had significantly better motor recovery in total Fugl-Meyer Assessment (p = 0.017) at a medium effect size (Cohen) of d = 0.7, due to a significant recovery of shoulder and elbow function (p = 0.003) in the Fugl-Meyer Assessment Part A subtest. For subjects with severe paresis, additional mirror therapy did not significantly influence outcome. CONCLUSION: Additional mirror therapy in combination with EMG-triggered multi-channel electrostimulation is therapeutically beneficial for post-acute strokepatients with very severe arm/hand paresis.
Authors: Maria Munoz-Novoa; Morten B Kristoffersen; Katharina S Sunnerhagen; Autumn Naber; Margit Alt Murphy; Max Ortiz-Catalan Journal: Front Hum Neurosci Date: 2022-05-20 Impact factor: 3.473
Authors: Martina Coscia; Maximilian J Wessel; Ujwal Chaudary; José Del R Millán; Silvestro Micera; Adrian Guggisberg; Philippe Vuadens; John Donoghue; Niels Birbaumer; Friedhelm C Hummel Journal: Brain Date: 2019-08-01 Impact factor: 13.501
Authors: Holm Thieme; Nadine Morkisch; Jan Mehrholz; Marcus Pohl; Johann Behrens; Bernhard Borgetto; Christian Dohle Journal: Cochrane Database Syst Rev Date: 2018-07-11