Intention-driven functional electrical stimulation therapy using a wearable high-density electrode sleeve in chronic stroke: a case report.

Only two participants were studied, and there was no control group, so the study cannot show that the intervention caused the improvements. The participants received several components together: occupational therapist-guided task-oriented therapy, operator-triggered FES, EMG-triggered FES, and repeated calibration, so the contribution of any single component cannot be separated. The 10-week follow-up was not a true no-treatment period because intermittent FES continued, so maintained gains cannot be attributed solely to the initial 8-week intervention. EMG-controlled sessions were limited to hand-open and hand-close movements and required new calibration and decoder training at each session, which limits generalisation to more complex tasks or home use. Both participants had moderate baseline impairment and were more than 2 years post stroke, so results may not apply to people with more severe hand weakness or recent stroke. Some assessments were missing, including the Box and Blocks Test for subject A at the 4-week follow-up due to an unrelated injury, and the Motor Activity Log was not an outcome measure. The authors did not quantitatively assess electrode placement variability, configuration consistency, or GUI usability, so practical reliability of the system is not fully established. Stroke factors such as lesion location, residual voluntary muscle activation, and EMG signal quality were not independently quantified, so responsiveness to EMG control is uncertain.

Do not conclude that the NeuroLife Sleeve or EMG-controlled FES alone caused the functional improvements. The participants received task-oriented therapy guided by an occupational therapist, operator-triggered FES, EMG-triggered FES, and repeated calibration, and the study had only two participants with no control group, so the contribution of any single component cannot be separated.