Efficacy of myoelectric bracing in moderately impaired stroke survivors: A randomized, controlled trial.

Abstract

Repetitive, task-specific practice increases functioning of the paretic upper extremity and decreases upper extremity motor impairment. One method to increase participation in repetitive, task-specific practice is an upper extremity myoelectric device, called the "Myomo", which uses surface electromyography signals to assist with active movement of the moderately impaired hemiplegic upper extremity. To determine the efficacy of regimens comprised of: () Myomo + repetitive, task-specific practice; () repetitive, task-specific practice only; and () Myomo only on outcomes for hemiplegic arm. Using a randomized, controlled, single-blinded design, 34 subjects (20 males; mean age 55.8 years), exhibiting chronic, moderate, stable, post-stroke, upper extremity hemiparesis, were included. Participants were randomized to one of the above conditions, and administered treatment for 1 h/day on 3 days/week over an 8-week period. The primary outcome measure was the upper extremity section of the Fugl-Meyer Impairment Scale (FM); the secondary measurement was the Arm Motor Activity Test (AMAT). The groups exhibited similar score increases of approximately +2 points, resulting in no differences in the amount of change on the FM (H= 0.376, = 0.83) and AMAT (H= 0.978 = 0.61). The results suggest that a therapeutic approach integrating myoelectric bracing yields highly comparable outcomes to those derived from repetitive, task-specific practice-only. Myoelectric bracing could be used as alternative for labour-intensive upper extremity training due to its equivalent efficacy to hands-on manual therapy with moderately impaired stroke survivors.