ELECTROSTIMULATION FOR STROKE REHABILITATION

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Previous studies have suggested that repetitive exercises facilitated by electromyograph (EMG)-controlled neuromuscular stimulation enhance the motor recovery of stroke survivors. However, those studies were poorly controlled, and mechanisms of action were not addressed. The aims of this project are to 1)assess the efficacy of EMG-controlled neuromuscular stimulation in enhancing the upper-extremity motor recovery of chronic stroke survivors, and 2) determine whether EMG-controlled neuromuscular stimulation mediates its effect on motor recovery via central measures of motor impairment. The focus of this protocol will consist of a single-blinded, randomized clinical trial to assess the effects of EMG-controlled neuromuscular stimulation on objective measures of motor impairment and measures of central motor function. Thirty-four chronic stroke survivors will be randomly assigned to either the EMG-controlled neuromuscular facilitation or control groups. Tripolar percutaneous electrodes that can detect weak EMG signals and deliver neuromuscular stimulation will be implanted in all subjects. The treatment will last four weeks and outcomes will be assessed at the end of treatment and at 12 weeks after treatment. This study will demonstrate that EMG-controlled neuromuscular stimulation enhances the motor recovery of chronic stroke survivors, and that the motor recovery is mediated by central mechanisms.