Browse > Article
http://dx.doi.org/10.20540/JIAPTR.2020.11.1.2012

Effect of a Combined Functional Electrical Stimulation with Action Observation Training on the Upper Limb Global Synkinesis and Function of Patients with Stroke  

Kang, Jeongil (Department of Physical Therapy, Sehan University)
Kim, Huikyeong (Department of Physical Therapy, Sehan University)
Jeong, Daekeun (Department of Physical Therapy, Sehan University)
Park, Seungkyu (Department of Physical Therapy, Sehan University)
Yang, Daejung (Department of Physical Therapy, Sehan University)
Kim, Jeho (Department of Physical Therapy, Sehan University)
Moon, Youngjun (JungDaun Hosipital)
Publication Information
Journal of International Academy of Physical Therapy Research / v.11, no.1, 2020 , pp. 2012-2020 More about this Journal
Abstract
Background: Multifaceted approaches will be needed, such as global synkinesis (GS) achieve functional improvements in the arms of stroke patients from involuntary movements during exercise. Objective: To identify changes in arm GS and muscle activity, functional evaluation and the correlation with variables through action observation training, combined with functional electrical stimulation (FES), thereby verifying the effect on stroke patients. Design: A quasi-experimental study. Methods: The subjects of this study were 20 stroke patients who were divided into two groups: Control group (n=10) and experimental group (n=10). Before the intervention, arm GS and muscle activity were measured using surface electromyography (EMG), and arm function was evaluated using the Fugl-Meyer Assessment (FMA) scale. At the end of the intervention, which lasted 4-wk, arm GS and muscle activity were measured again using the same scale. Results: There was a decrease statistically significant difference in GS during the bending action in experimental group (P<.01). Both groups showed a significant difference increased only in the activity of the anterior deltoid (AD) and biceps brachii (BB) (P<.05). The results of the arm functional assessment revealed a significant difference increase in both groups (P<.05). In the between-group comparison, there was a significant difference decrease in GS during the bending action (P<.05). Only the muscle activity of the AD and BB were significantly increase different (P<.05). There was a significant between-group difference increase in the arm functional assessment (P<.05). There was a positive correlation between GS and muscle activity on the FMA in the control group (r=.678, P<.05). In experimental group, GS during the bending arm action exhibited a negative correlation (r=-.749, P<.05), and the muscle activity of the AD and BB showed a positive correlation (r=.701, P<.05). Furthermore, in experimental group, the activity of the extensor carpi radialis increased, and the activity of the flexor carpi radialis decreased, which exhibited a negative correlation (r=-.708, P<.05). Conclusion: These results suggest that brain plasticity could be more efficiently stimulated by combining surface stimulation in the affected arm of stroke patients.
Keywords
Stroke; Upper limb; Functional electrical stimulation; Action observation training; Global synkinesis;
Citations & Related Records
Times Cited By KSCI : 3  (Citation Analysis)
연도 인용수 순위
1 Chen YT, Li S, Magat E, Zhou P, Li S. Motor overflow and spasticity in chronic stroke share a common pathophysiological process: analysis of within-limb and between-limb EMG-EMG coherence. Front Neurol. 2018;9.
2 Kang KK, Nam KW. Effect of the increased sympathetic outflow on the changes of muscle tone and central nervous system excitability in chronic Stroke patients. J Korea Academia-Industrial. 2011;12(11):5019-5026.   DOI
3 Rueda FM, Montero FR, de Heredia Torres MP, Diego IA, Sánchez AM, Page JM. Movement analysis of upper extremity hemiparesis in patients with cerebrovascular disease: a pilot study. Neurologia. 2012;27(6):343-347.   DOI
4 Yun SY, Lee TY, Park SY, Yi JB, Kim JH. Muscle Activity and a Kinematic Analysis of Drinking Motion. Korean J of Occup Ther. 2008;16(1):77-88.
5 Kim T, Kim S, Lee B. Effects of action observational training plus brain-computer interfacebased functional electrical stimulation on paretic arm motor recovery in patient with stroke: A randomized controlled trial. Occup ther Int. 2016;23(1):39-47.   DOI
6 Van peppen RP, Kwakkel G, Wood-Dauphinee S, Hendriks HJ, Van der Wees PJ, Dekker J. The impact of physical therapy on functional outcomes after stroke: what's the evidence? Clin rehabil. 2004;18(8):833-862.   DOI
7 Davis GM, Hamzaid NA, Fornusek C. Cardiorespiratory, metabolic, and biomechanical responses during functional electrical stimulation leg exercise: health and fitness benefits. Artif organs. 2008;32(8):625-629.   DOI
8 Canning CG, Ada L, O'Dwyer NJ. Abnormal muscle activation characteristics associated with loss of dexterity after stroke. J Neurol Sci. 2000;176(1):45-56.   DOI
9 Lacourse MG, Orr EL, Cramer SC, Cohen MJ. Brain activation during execution and motor imagery of novel and skilled sequential hand movements. Neuroimage. 2005;27(3):505-519.   DOI
10 Ellis MD, Carmona C, Drogos J, Dewald J. Progressive abduction loading therapy with horizontal-plane viscous resistance targeting weakness and flexion synergy to treat upper limb function in chronic hemiparetic stroke: a randomized clinical trial. Front Neurol. 2018;9:71.   DOI
11 LagoRodriguez A, Cheeran B, Koch G, Hortobagy T, FernandezdelOlmo M. The role of mirror neurons in observational motor learning: an integrative review. European J Human Movement. 2014;32:82-103.
12 Mathieson S, Parsons J, Kaplan MS. Combining Functional Electrical Stimulation with Mirror Therapy for the upper limb in people with stroke. Critical Reviews Phys Rehabil Med. 2014;26(1-2).
13 Kang J, Kim H, Jeong D. Correlation between Affected Arm Muscle Activity and Global Synkinesis in Patients with Stroke. IAPTR. 2019;10(3):1856-1861.
14 Small SL, Buccino G, Solodkin A. The mirror neuron system and treatment of stroke. Dev Psychobiol. 2012;54(3):293-310.   DOI
15 Rand D. Proprioception deficits in chronic stroke Upper extremity function and daily living. PloS one. 2018;13(3).
16 Franck JA, Smeets RJEM, Seelen HAM. Changes in arm-hand function and arm-hand skill performance in patients after stroke during and after rehabilitation. PloS one. 2017;12(6).
17 Lang CE, Bland MD, Bailey RR, Schaefer SY, Birkenmeier RL. Assessment of upper extremity impairment, function, and activity after stroke: foundations for clinical decision making. J Hand Ther. 2013;26(2):104-114.   DOI
18 Knippenberg E, Verbrugghe J, Lamers I, Palmaers S, Timmermans A, Spooren A. Markerless motion capture systems as training device in neurological rehabilitation: a systematic review of their use, application, target population and efficacy. J Neuroeng Rehabil. 2017;14(1):61.   DOI
19 Sugg K, Müller S, Winstein C, Hathorn D, Dempsey A. Does action observation training with immediate physical practice improve hemiparetic upper-limb function in chronic stroke? Neurorehabil Neural Repair. 2015;29(9):807-817.   DOI
20 Sale P, Franceschini M, Mazzoleni S, Palma E, Agosti M, Posteraro F. Effects of upper limb robot-assisted therapy on motor recovery in subacute stroke patients. J neuroeng Rehabil. 2014;11:104.   DOI
21 Dobkin BH, Dorsch A. New evidence for therapies in stroke rehabilitation. Curr Atheroscler Rep. 2013;15(6):331.   DOI
22 Hwang IS, Tung LC, Yang JF, Chen YC, Yeh CY, Wang CH. Electromyographic analyses of global synkinesis in the paretic upper limb after stroke. Phys Ther. 2005;85(8):755-765.   DOI
23 Boissy P, Bourbonnais D, Gravel D, Arsenault AB, Lepage Y. Effects of upper and lower limb static exertions on global synkineses in hemiparetic subjects. Clin Rehabil. 2000;14(4):393-401.   DOI
24 World Health Organization. Stroke, Cerebrovascular accident. 2014.
25 Ejaz N, Xu J, Branscheidt M, et al. Finger recruitment patterns during mirror movements suggest two systems for hand recovery after stroke. bioRxiv. 2017;129510.
26 Mangold S, Schuster C, Keller T, ZimmermannSchlatter A, Ettlin T. Motor training of upper extremity with functional electrical stimulation in early stroke rehabilitation. Neurorehabil Neural Repair. 2009;23(2):184-190.   DOI
27 You DH, Lee JS, Jeon BJ, et al. Effect of taskoriented training on upper extremity during functional electrical stimulation in stroke patients. Korean J of Occup Ther. 2011;19(4):25-39.
28 Yang DJ, Uhm YH, Kim JH. The biofeedback scapular stabilization exercise in stroke patients effect of muscle activity and function of the upper extremity. J Kor Phys Ther. 2015;27(5):325-331.   DOI
29 Robson N, Faller II, Ahir V. Creating a Virtual Perception for Upper Limb Rehabilitation. Stroke. 2017;12:15.
30 Kim JY, Ko YM, Park JW. Comparison of EEG Changes Induced by Action Execution and Action Observation. J Kor Phys Ther. 2017;29(1):27-32.   DOI
31 Alon G, Levitt AF, McCarthy PA. Functional electrical stimulation enhancement of upper extremity functional recovery during stroke rehabilitation: a pilot study. Neurorehabil Neural Repair. 2007;21(3):207-215.   DOI
32 Suiter DM, Leder SB, Ruark JL. Effects of neuromuscular electrical stimulation on submental muscle activity. Dysphagia. 2006;21(1):56-60.   DOI
33 Kern H. Functional electrical stimulation on paraplegic patients. Euro J Transla Myology. 2014;24(2).
34 Yang SH, Rhee WI, Son SG, Kwon SY, Kim MG. Analysis of Upper Extremity Motion during Drinking Using Virtual Reality Motion Analysis System (VRMAS). J Kor Academy Rehabil Med. 1998;22(1):204-209.
35 Nelles G, Cramer SC, Schaechter JD, Kaplan JD, Finklestein SP. Quantitative assessment of mirror movements after stroke. Stroke. 1998;29(6):1182-1187.   DOI
36 Moon YJ. The Effect of Dynamic Neural Mobilization on Arm Nerve Conduction Velocity, Functions and Cerebral Cortex Activity for Patients with Stroke [thesis]. Yeongam: Sehan University; 2018.
37 Buccino G, Binkofski F, Fink GR, et al. Action Observation Activates Premotor and Parietal Areas in a Somatotopic Manner: An fMRI Study. Eur J neurosci. 2001;13(2):400-404.   DOI