Objective: To gain experience with ‘Ness Handmaster Orthosis’ treatment in chronic stroke patients, to identify suitable patients, and to study the effects of treatment.
Design: Exploratory, uncontrolled trial with measurement of motor functions and muscle tone of the upper extremity prior to, during, upon completion, and six weeks after a treatment period.
Setting: A rehabilitation centre in the Netherlands.
Subjects: Eighteen chronic stroke patients (more than six months post stroke), who exhibited upper extremity dysfunction due to spastic paresis.
Intervention: A 10-week therapy programme of functional electrical stimulation by means of the ‘Ness Handmaster Orthosis’.
Results: The results of 15 patients were available for analysis. The differences in motor score and muscle tone before and at the end of treatment were statistically significant (p = 0.008 and 0.021, respectively). The follow-up measurements showed that the effects on motor functions and muscle tone decreased after therapy completion. Stratification of the patients in two subgroups indicated that patients with initial high motor scores benefited most during the intervention period.
Conclusion: The present study suggests that Handmaster treatment possesses therapeutic opportunities in chronic stroke patients with spastic paresis of the upper extremity.
Get full access to this article
View all access options for this article.
References
1.
Nakayama H, Jorgensen HS, Raaschou HO, Olsen TS. The recovery of the upper extremity function in stroke patients: the Copenhagen study. Arch Phys Med Rehabil1994; 75: 1–5.
2.
Heller A, Wade DT, Wood VA, Sunderland A, Langton-Hewer R, Ward E. Arm function after stroke: measurement and recovery over the first three months. J Neurol Neurosurg Psychiatry1987; 50: 714–719.
3.
Wade DT, Langton-Hewer R, Wood VA, Skilbeck CE, Ismail HM. The hemiplegic arm after stroke: measurement and recovery. J Neurol Neurosurg Psychiatry1983; 46: 521–524.
4.
Caldwell CB, Wilson DJ, Braun RM. Evaluation and treatment of the upper extremity in the hemiplegic stroke patient. Clin Orthop Rel Res1969; 63: 69–92.
5.
Glanz M, Klawansky S, Stason W, Berkey C, Chalmers T. Functional electrostimulation in poststroke rehabilitation: a meta-analysis of the randomized controlled trials. Arch Phys Med Rehabil1996; 77: 549–553.
6.
Chae J, Bethoux F, Bohinc T, Dobos L, Davis T, Friedl A. Neuromuscular stimulation for upper extremity motor and functional recovery in acute hemiplegia. Stroke1998; 29: 975–979.
7.
Faghri PD, Rodgers MM, Glaser RM, Bors JG, Ho C, Akuthota P. The effects of functional electrical stimulation on shoulder subluxation, arm function recovery, and shoulder pain in hemiplegic stroke patients. Arch Phys Med Rehabil1994; 75: 73–79.
8.
Francisco G, Chae J, Chawla H et al. Electromyogram-triggered neuromuscular stimulation for improving the arm function of acute stroke survivors: a randomized pilot study. Arch Phys Med Rehabil1989; 79: 570–575.
9.
Weingarden HP, Kizony R, Nathan R, Ohry A, Levy H. Upper limb functional electrical stimulation for walker ambulation in hemiplegia. A case report. Arch Phys Med Rehabil1997; 76: 63–67.
10.
IJzerman M, Stoffers T, In 't Groen F et al. Experiences with the clinical application of the Ness Handmaster in C5 tetraplegic and stroke patients: a pilot study. J Rehabil Sci1996; 9: 86–89.
11.
Weingarden HP, Zeilig G, Heruti R et al. A hybrid functional electrical stimulation orthosis system for the upper limb. Am J Phys Med Rehabil1998; 77: 276–281.
12.
Bohannon RW, Smith MB. Interrater reliability of a modified Ashworth scale of muscle spasticity. Phys Ther1987; 67: 206–207.
13.
Fugl-Meyer AR, Jaasko L, Leyman I, Olsson S, Steglind S. The poststroke hemiplegic patient. Part I. A method for evaluation of physical performance. Scand J Rehabil Med1975; 7: 13–31.
