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Assisted movement with proprioceptive stimulation reduces impairment and restores function in incomplete spinal cord injury.

AbstractOBJECTIVE:
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.
AuthorsDeborah Backus, Paul Cordo, Amanda Gillott, Casey Kandilakis, Motomi Mori, Ahmed M Raslan
JournalArchives of physical medicine and rehabilitation (Arch Phys Med Rehabil) Vol. 95 Issue 8 Pg. 1447-53 (Aug 2014) ISSN: 1532-821X [Electronic] United States
PMID24685386 (Publication Type: Journal Article)
CopyrightCopyright © 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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