Feasibility and clinical experience of implementing a myoelectric upper limb orthosis in the rehabilitation of chronic stroke patients: A clinical case series report

PLoS One. 2019 Apr 12;14(4):e0215311. doi: 10.1371/journal.pone.0215311. eCollection 2019.

Abstract

Individuals with stroke are often left with persistent upper limb dysfunction, even after treatment with traditional rehabilitation methods. The purpose of this retrospective study is to demonstrate feasibility of the implementation of an upper limb myoelectric orthosis for the treatment of persistent moderate upper limb impairment following stroke (>6 months).

Methods: Nine patients (>6 months post stroke) participated in treatment at an outpatient Occupational Therapy department utilizing the MyoPro myoelectric orthotic device. Group therapy was provided at a frequency of 1-2 sessions per week (60-90 minutes per session). Patients were instructed to perform training with the device at home on non-therapy days and to continue with use of the device after completion of the group training period. Outcome measures included Fugl-Meyer Upper Limb Assessment (FM) and modified Ashworth Scale (MAS).

Results: Patients demonstrated clinically important and statistically significant improvement of 9.0±4.8 points (p = 0.0005) on a measure of motor control impairment (FM) during participation in group training. It was feasible to administer the training in a group setting with the MyoPro, using a 1:4 ratio (therapist to patients). Muscle tone improved for muscles with MAS >1.5 at baseline.

Discussion: Myoelectric orthosis use is feasible in a group clinic setting and in home-use structure for chronic stroke survivors. Clinically important motor control gains were observed on FM in 7 of 9 patients who participated in training.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Arm* / physiopathology
  • Electromyography / instrumentation
  • Electromyography / statistics & numerical data
  • Equipment Design
  • Feasibility Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Occupational Therapy
  • Orthotic Devices* / statistics & numerical data
  • Recovery of Function
  • Retrospective Studies
  • Stroke / physiopathology*
  • Stroke Rehabilitation / instrumentation*
  • Stroke Rehabilitation / methods

Grants and funding

All patients received therapy as part of their standard clinical care. All therapy was provided by the Occupational Therapy Department staff at the Cleveland VA Medical Center. Brace fabrication was completed by the orthotist for Myomo as part of the patients’ clinical care at the medical center. Myomo provided an unrestricted grant to support a statistician, however Myomo had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.