The effects of electromyography-controlled functional electrical stimulation on upper extremity function and cortical perfusion in stroke patients

Yukihiro Hara, Shigeru Obayashi, Kazuhito Tsujiuchi, Yoshihiro Muraoka

    Research output: Contribution to journalArticle

    50 Citations (Scopus)

    Abstract

    Objective: The relation was investigated between hemiparetic arm function improvement and brain cortical perfusion (BCP) change during voluntary muscle contraction (VOL), EMG-controlled FES (EMG-FES) and simple electrical muscle stimulation (ES) before and after EMG-FES therapy in chronic stroke patients. Methods: Sixteen chronic stroke patients with moderate residual hemiparesis underwent 5. months of task-orientated EMG-FES therapy of the paretic arm once or twice a week. Before and after treatment, arm function was clinically evaluated and BCP during VOL, ES and EMG-FES were assessed using multi-channel near-infrared spectroscopy. Results: BCP in the ipsilesional sensory-motor cortex (SMC) was greater during EMG-FES than during VOL or ES; therefore, EMG-FES caused a shift in the dominant BCP from the contralesional to ipsilesional SMC. After EMG-FES therapy, arm function improved in most patients, with some individual variability, and there was significant improvement in Fugl-Meyer (FM) score and maximal grip strength (GS). Clinical improvement was accompanied by an increase in ipsilesional SMC activation during VOL and EMG-FES condition. Conclusion: The EMG-FES may have more influence on ipsilesional BCP than VOL or ES alone. Significance: The sensory motor integration during EMG-FES therapy might facilitate BCP of the ipsilesional SMC and result in functional improvement of hemiparetic upper extremity.

    Original languageEnglish
    Pages (from-to)2008-2015
    Number of pages8
    JournalClinical Neurophysiology
    Volume124
    Issue number10
    DOIs
    Publication statusPublished - 2013 Oct

    Fingerprint

    Electromyography
    Upper Extremity
    Electric Stimulation
    Perfusion
    Stroke
    Brain
    Arm
    Muscles
    Therapeutics
    Near-Infrared Spectroscopy
    Hand Strength
    Paresis
    Muscle Contraction
    Skeletal Muscle
    Sensorimotor Cortex

    Keywords

    • Brain perfusion
    • CBF
    • EMG
    • EMG-FES
    • ES
    • FES
    • FMRI
    • Functional electrical stimulation
    • NIRS
    • Rehabilitation
    • SIAS
    • SMC
    • Stroke
    • VOL

    ASJC Scopus subject areas

    • Clinical Neurology
    • Neurology
    • Physiology (medical)
    • Sensory Systems

    Cite this

    The effects of electromyography-controlled functional electrical stimulation on upper extremity function and cortical perfusion in stroke patients. / Hara, Yukihiro; Obayashi, Shigeru; Tsujiuchi, Kazuhito; Muraoka, Yoshihiro.

    In: Clinical Neurophysiology, Vol. 124, No. 10, 10.2013, p. 2008-2015.

    Research output: Contribution to journalArticle

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