Feasibility of electromyography-triggered neuromuscular stimulation as an adjunct to constraint-induced movement therapy

Background and Purpose. The purpose of this case report is to explore the feasibility of electromyography-triggered neuromuscular stimulation (EMG-stim) as an adjunct to constraint-induced movement therapy (CIMT). Case Description. The patient was a 72-year-old man, 10 years poststroke, who did not meet traditional CIMT criteria. The EMG-stim was applied to the wrist extensors of the patient's weaker arm for one half of the CIMT training hours. Outcomes. The intervention was feasible for this individual. Improvements were observed in motor behavior, quality and amount of use, muscle activity, wrist range of motion, and reaction time of the more-affected extremity. These improvements were paralleled by a change in the size and location of the extensor digitorum communis muscle representation in the primary motor cortex, as measured by transcranial magnetic stimulation mapping. Discussion. These changes suggest that using EMG-stim as an adjunct to CIMT should be further investigated in individuals who have low functional abilities following stroke. [Fritz SL, Chiu YP, Malcolm MP, et al. Feasibility of electromyography-triggered neuromuscular stimulation as an adjunct to constraint-induced movement therapy.