Functional Electrical Therapy (FET): Clinical Trial in Chronic Hemiplegic Subjects

Abstract

Results from a clinical evaluation of Functional Electrical Therapy (FET) in chronic hemiplegic subjects are presented. FET is an intensive exercise that integrates voluntary maximized manipulation and augmented grasping by electrical stimulation of forearm and hand muscles. A total of 16 chronic hemiplegic subjects participated in a six-month long study. The subjects were divided into lower and higher functioning groups based on their capacity to voluntarily extend the wrist and fingers against gravity. Functional Electrical Therapy comprised 30-min electrically assisted daily exercise of the paretic arm for three consecutive weeks. The outcome measures included Upper Extremity Function Test (UEFT), the Drawing Test (DT), and Modified Ashworth Scale (MAS) of spasticity. The UEFT objectively measured the abilities to grasp and manipulate objects during typical daily activities. The DT measured the ability to coordinate shoulder and elbow joints. The MAS assessed the tone of the paretic arm muscles. The control group was formed from hemiplegic subjects that received FET in their acute phase of hemiplegia and were evaluated in our earlier study. The results showed that FET slightly increases the ability to reach and grasp, and decreases absolute mean spasticity of chronic hemiplegic subjects. The gains in UEFT and DT were measurable, yet not statistically significant. The trends of UEFT and DT scores during the therapy (three weeks) were steeper when compared with the trend during follow-up (23weeks). The changes of the trends during the study suggest that prolonged treatment could lead to bigger gains. We found standard deviations were increased towards the end of follow-up suggesting individual differences in response to either the treatment or the disablement process.