Hand - Function Control

Contralaterally controlled Functional Electrical Stimulation (FES) for recovery of hand function after Stroke.

Principal Investigator: Jayme Knutson, Ph.D.
Clinical Coordinator: Peggy Maloney, R.N.
Contact Number: (216) 778-8563
Contact Email: mmaloney@metrohealth.org

 
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.

PROGRAM

Electrical Stimulation for Recovery of Hand Function in Chronic and Acute Stroke Survivors

Purpose:  The purpose of this program is to develop and test electrical stimulation devices and therapies that help stroke survivors recover hand function.  A temporary regimen (several weeks) of transcutaneous (surface of the skin) electrical stimulation may produce changes in the central nervous system that lead to recovery of hand motor control.  This program investigates what electrical stimulation therapies lead to the best results.

Objective:  This program is for individuals who have had a stroke that has caused loss of hand function.  Two randomized controlled trials are underway.  One is for stroke patients who are within 6 months of their stroke (acute), and the other is for stroke patients who are past 6 months post-stroke (chronic).  In both of these studies, the participants are randomly assigned either Contralaterally Controlled FES or Cyclic Neuromuscular Electrical Stimulation treatment.  Both of these treatments use electrical stimulation to open the hand.  Both treatments consist of using the stimulator at home approximately two hours per day and coming to the laboratory twice a week to work with an occupational therapist.  The treatment period is 6 to 12 weeks long.  The participants’ ability to open their hand and use it to perform tasks is assessed before and after the treatment and every 2 months for six months after the treatment has ended.

Detailed program information and criteria available at http://clinicaltrials.gov/ct2/show/NCT00891319

The goals of this large, multi-center clinical trial are to more definitively research the promise of surface stimulation for paretic wrist and hand muscles.



CCFES Hand system



Contralaterally Controlled Functional Electrical Stimulation for recovery of hand movement.