Effect of Passive Limb Activation by Functional Electrical Stimulation on Wheelchair Driving in Patients with Unilateral Spatial Neglect: A Case Study.
Nao Yoshihiro, Emi Ito
PMID 30186076WHAT IT FOUND
Functional electrical stimulation to the affected forearm helped a stroke patient with left neglect drive farther during wheelchair practice, but did not help the other and did not last after stopping.
Key findings
01For participant 1, driving distance increased significantly during the intervention phase compared with baseline and later baseline.
02For participant 2, driving distance did not increase during the intervention phase, and collisions did not decrease during the intervention phase in either direction.
03Functional electrical stimulation produced only slight wrist extension in participant 2.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
Only two participants were analysed, and one of the three patients who participated dropped out, so this cannot show what would happen in a larger group. The driving distance gain for participant 1 did not last after the stimulation phase ended. Collisions did not show a clear benefit from stimulation for participant 1, and participant 2's collisions did not decrease during stimulation in either direction. The stimulation produced only slight wrist movement in participant 2, so the physical response may have been too small to help. The study did not compare brain images before, during, or after the intervention. The study tested only wheelchair driving, not other daily activities such as eating, shaving, dressing, or getting up.
The easy way to misread this
Do not conclude that functional electrical stimulation improves wheelchair driving for patients with unilateral spatial neglect. The patient who improved drove farther only during stimulation, the gain did not last after stimulation stopped, and the other patient did not improve.