Hand – Function Control (Stroke < 2 years ago)

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Overview

Loss of hand function is common after stroke. Usually some hand movement returns but often not enough movement returns to make the hand functional again. Electrical stimulation can be used to open the hands of stroke survivors. This can be done with electrodes that adhere to the skin on the back of the forearm. If electrical stimulation is delivered at the same time the patient attempts to open the hand, there may be a greater chance for recovery (or relearning) of hand movement and control. If electrical stimulation is controlled by the patient, the effect on motor recovery might be even greater. Researchers at the Cleveland FES Center have developed a new treatment in which stroke survivors control stimulation to their weak hand through a glove worn on their unaffected hand. This new treatment is called Contralaterally Controlled Functional Electrical Stimulation, or CCFES.

 

Contralaterally Controlled FES of Arm & Hand for Subacute Stroke Rehabilitation

Purpose: Impaired arm and hand function is one of the most disabling and most common consequences of stroke. The Investigators have developed Contralaterally Controlled Functional Electrical Stimulation (CCFES), an innovative neuromuscular electrical stimulation (NMES) treatment for improving the recovery of hand function after stroke. The purpose of this study is to maximize the treatment effect of CCFES by adding stimulated elbow extension. The specific aims and hypotheses are as follows:

  • Estimate the effect of Arm+Hand CCFES on upper limb motor impairment and activity limitation.
    • Stroke survivors treated with Arm+Hand CCFES are expected to have better outcomes on upper limb impairment and activity limitation measures than those treated with dose-matched Arm+Hand Cyclic NMES.
  • Estimate the effect of adding stimulated elbow extension to Hand CCFES.
    • Stroke survivors treated with Arm+Hand CCFES will have greater reductions in upper limb impairment and activity limitation than those treated with Hand CCFES.
  • Describe the relationship between treatment effect and time elapsed between stroke onset and start of treatment.
    • Patients who start Arm+Hand CCFES sooner after their stroke achieve better outcomes.

Objective: The primary objective of this project is to estimate the effect of Arm+Hand Contralaterally Controlled Functional Electrical Stimulation (CCFES) reducing upper limb motor impairment and activity limitation in subacute hemiplegia. Arm+Hand CCFES therapy is intended to strengthen and improve the motor control of the proximal upper limb as well as the hand, to improve simultaneous reaching and hand opening, a functionally critical movement pattern that is often prevented by paresis and post-stroke flexor synergies. The secondary objective of this project is to evaluate the effect of adding elbow extensor stimulation to the Hand CCFES treatment.

Detailed program information and criteria available at:
https://clinicaltrials.gov/ct2/show/NCT01688856?term=contralaterally+controlled+FES+of+arm+%26+hand&rank=1

 

Principal Investigator: Jayme Knutson, PhD
Clinical Coordinator: Peggy Maloney, RN
Contact Number: (216) 957-3558
Contact Email: mmaloney@metrohealth.org