Abstract | OBJECTIVE: To test whether treatment with assisted movement with enhanced sensation (AMES) using vibration to the antagonist muscle would reduce impairments and restore upper limb function in people with incomplete tetraplegia. DESIGN: Prospective, pre-post study. SETTING: Laboratory and rehabilitation hospital. PARTICIPANTS: We recruited 15 arms from 10 individuals (8 men; mean age, 40.5 y; mean years postspinal cord injury [SCI], 3) with chronic, incomplete tetraplegia. INTERVENTION: Two or three 20-minute sessions per week over 9 to 13 weeks (25 sessions total) on the AMES device, which combines repeated movement with targeted vibration to the antagonist muscle. MAIN OUTCOME MEASURES: Strength and active motion tests on the AMES device; International Standards for the Neurological Classification of SCI (ISNCSCI) motor and sensory examinations; Modified Ashworth Scale (MAS); grasp and release test (GRT); Van Lieshout Test (VLT); and Capabilities of Upper Extremity questionnaire (CUE). RESULTS: The AMES strength test scores improved significantly in metacarpophalangeal flexion (P=.024) and extension (P=.007) and wrist flexion (P=.001) and extension (P<.000). The AMES active motion scores improved in the hand (P=.001) and wrist (P=.001). The MAS and ISNCSCI scores remained unchanged, whereas the GRT scores increased (P=.025). Post hoc analysis showed a trend from pre- to posttreatment (P=.068) and a significant change from pretreatment to 3-month follow-up (P=.046). There was no significant change in the VLT (P=.951) or the CUE (P=.164). Five of the 10 participants reported a return of sensation to the digits after the first, second, or third treatment session. CONCLUSIONS: People with chronic, incomplete tetraplegia may experience improvements in impairments and function after treatment on a device combining assisted movement and proprioceptive stimulation. Further investigation is warranted.
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Authors | Deborah Backus, Paul Cordo, Amanda Gillott, Casey Kandilakis, Motomi Mori, Ahmed M Raslan |
Journal | Archives of physical medicine and rehabilitation
(Arch Phys Med Rehabil)
Vol. 95
Issue 8
Pg. 1447-53
(Aug 2014)
ISSN: 1532-821X [Electronic] United States |
PMID | 24685386
(Publication Type: Journal Article)
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Copyright | Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved. |
Topics |
- Adult
- Aged
- Female
- Fingers
(physiopathology)
- Humans
- Male
- Metacarpophalangeal Joint
(physiopathology)
- Middle Aged
- Movement
- Muscle Strength
- Muscle, Skeletal
(physiopathology)
- Musculoskeletal Manipulations
- Proprioception
(physiology)
- Quadriplegia
(etiology, physiopathology, rehabilitation)
- Recovery of Function
- Sensation
- Spinal Cord Injuries
(complications, rehabilitation)
- Vibration
(therapeutic use)
- Wrist
(physiopathology)
- Young Adult
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