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Stroke motor recovery: active neuromuscular stimulation and repetitive practice schedules

University of Florida, Gainesville, Florida, USA

Correspondence to:
Correspondence to:
Dr James Cauraugh, Motor Behavior Laboratory, PO Box 118206, University of Florida, Gainesville, Florida 32611, USA;
jcaura{at}hhp.ufl.edu

Design:To increase voluntary control of the upper extremity, active neuromuscular stimulation was administered during blocked and random practice schedules as patients performed three specific movements: wrist/finger extension, elbow joint extension, and shoulder joint abduction.

Methods:34 stroke subjects volunteered to participate and were randomly assigned to one of three treatment groups: blocked practice (the same movement was repetitively performed on successive trials) combined with active neuromuscular stimulation; random practice (different movements on successive trials) along with active stimulation; or no active stimulation assistance control group. Subjects completed two days of 90 minute training for each of two weeks with at least 24 hours of rest between sessions. A session was three sets of 30 successful active neuromuscular stimulation trials with the three movements executed 10 times/set.

Results:Mixed design analyses on three categories of behavioural measures indicated motor improvements for the blocked and random practice/stimulation groups in comparison with the control group during the post-test period, with a larger number of blocks moved, faster premotor and motor reaction times, and less variability in the sustained muscular contraction task.

Conclusions:Upper extremity rehabilitation intervention of active stimulation and blocked practice performed as well as stimulation/random practice. Moreover, these purposeful voluntary movement findings support and extend sensorimotor integration theory to both practice schedules.

Keywords: stroke motor recovery; active neuromuscular stimulation; practice schedule

Relevant Article

Stroke: neuroplasticity and recent approaches to rehabilitation

R M Bracewell
J. Neurol. Neurosurg. Psychiatry 2003 74: 1465. [Extract] [Full Text] [PDF]

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