Transition of a severely hemiparetic upper limb to a supporting upper limb: Development of a purposeful activity-electrical stimulation therapy rehabilitation programme（A report of three cases）

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Abstract

Objective: This study combined occupational therapy （OT） and a functional electrical stimulation hand rehabilitation system to investigate their effects on training a severely hemiparetic upper limb due to cerebral stroke for use as a supporting limb. Method: Subjects were all three individuals who consented to participate. At 50.3 ± 32.2 （mean ± SD） months after stroke onset, at initial evaluations, they scored a mean of 34.7 ± 8.3 points on the Fugl–Mayer Assessment （FMA） of motor function and 0.24 ± 0.34 and 0.21 ± 0.3 on the amount of use （AOU） and quality of movement （QOM） components of the Motor Activity Log （MAL）, respectively. The therapy comprised conducting visiting OT matched to patients' daily life goals at least once a week and EST matched to the activities of daily living as at-home training at least thrice a week for 10–60 min for approximately 7 months. Results: Results were 56.0 ± 6.2 on the FMA and 1.05 ± 0.23 and 1.05 ± 0.1 on the AOU and QOM components of the MAL, respectively, demonstrating the use of the affected upper limb. Conclusion: Therefore, this study suggested improving techniques to encourage the use of an upper limb with severe paresis in daily living.

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