Volumen 64, Número 3 Revista de la Facultad de Medicina

Publicado

2016-07-01

Use of EMG biofeedback for basic activities of daily living training in stroke patients. Pilot randomized clinical trial

Uso de biofeedback electromiográfico durante el entrenamiento de las actividades básicas de la vida diaria en pacientes con accidente cerebrovascular. Ensayo clínico aleatorizado piloto

Palabras clave:

Neurorretroalimentación, Rehabilitación, Actividades cotidianas, Accidente cerebrovascular, Terapia Ocupacional (en)
Neurorretroalimentación, Rehabilitación, Actividades cotidianas, Accidente cerebrovascular, Terapia Ocupacional (es)

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Autores/as

  • Maricel Garrido-Montenegro Hospital Clínico Universidad de Chile - Physical Medicine and Rehabilitation Service - Santiago - Chile.
  • Evelyn Álvarez-Espinoza Hospital Clínico Universidad de Chile - Physical Medicine and Rehabilitation Service - Santiago - Chile. Universidad Central de Chile - Faculty of Health Sciences - Occupational Therapy School - Santiago - Chile.
  • Sebastián Vergara-Ruiz Hospital Clínico Universidad de Chile - Physical Medicine and Rehabilitation Service - Santiago - Chile.

Introduction: Sequels in stroke patients include hemiparesis and dependency for performing basic activities of daily living (BADL). EMG biofeedback has yielded some benefits but has been limited to repetitive movement, therefore, it is insufficient for current task-oriented neurorehabilitation paradigms.

Objective: To assess whether the application of EMG biofeedback in upper limbs during BADL training improves motor, occupational and satisfaction performances compared to BADL training without this feedback.

Materials and methods: A pilot randomized clinical trial was conducted with stroke patients of more than six months of evolution, who showed hemiparesis and no cognitive deterioration. These patients were randomly classified into two groups: control group, who underwent conventional occupational therapy (COT), and experimental group, who underwent COT+EMG-BF. Patients were given 10 therapy sessions. Entry, evaluation and data analysis were masked.

Results: Seven patients were included in each group, showing the same initial clinical and demographic characteristics (p>0.05). The group that underwent COT+EMG-BF showed a significantly better performance in all assessments. For example, the Barthel scale obtained a median of 100 points [85-100] for the COT+EMG-BF group versus 85 [80-90] for the control group (p<0.05), whereas ARAT score was 42 [40-47] points versus 20 [15-38] (p=0.03), respectively.

Conclusion: The combination of COT+EMG-BF for BADL may be considered as an alternative for treatment of stroke patients.

Introducción. Las principales secuelas del accidente cerebrovascular (ACV) son la hemiparesia y la dependencia en actividades básicas de la vida diaria (ABVD). El biofeedback electromiográfico (BF-EMG) ha mostrado beneficios, pero su uso se ha centrado en el entrenamiento de movimientos aislados, lo que difiere del paradigma actual en rehabilitación.

Objetivo. Evaluar si la aplicación de BF-EMG durante el entrenamiento de ABVD mejora el nivel de independencia, el funcionamiento motor y la satisfacción en el desempeño comparado con entrenamiento de ABVD sin esta técnica.

Materiales y métodos. Ensayo clínico piloto en pacientes de 18 a 70 años con hemiparesia secundaria a ACV isquémico crónico. Los pacientes fueron aleatorizados en dos grupos: un grupo control con terapia ocupacional convencional (TOC) o un grupo experimental con TOC + BF-EMG. Se enmascaró el enrolamiento, la evaluación y el análisis de datos.

Resultados. Se reclutaron siete pacientes en cada grupo, control y experimental, con las mismas características demográficas y clínicas iniciales (p>0.05). El grupo TOC+BF-EMG mostró mejor rendimiento en todas las evaluaciones. En el índice de Barthel se obtuvo una mediana de 100 puntos (85-100) para el grupo TOC + BF-EMG en comparación a 85 (80-90) del grupo control (p<0.05), mientras que en el test de Arat fueron 42 (40-47) puntos frente a 20 (15-38) (p=0.03), respectivamente.

Conclusión. La combinación de TOC + BF-EMG en ABVD podría considerarse una alternativa en el tratamiento de personas con ACV.

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Citas

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