FAME: Functional Assessment of a Myoelectric Orthosis Hand Orthoses

Functional Assistance Provided by Myoelectric Elbow-wrist- Hand Orthosis

The primary study objective is to compare post-stroke upper extremity (UE) movement while wearing a brace called the MyoPro 2 Motion G versus UE movement while wearing a resting splint and no device in stroke survivors with moderate UE dysfunction. During the study, subjects will undergo general training in the operation of the EMG-controlled orthosis and the comparison orthosis, and then guided through a series of standard clinical outcome measures. These outcome measures will allow the researchers to directly compare the relative benefit of the MyoPro 2 Motion G with a resting hand splint and no device in reducing UE impairment and increasing UE dexterity and functional task performance.

Inclusion Criteria:

• Manual Muscle Test >1/5 in the paretic biceps, triceps, finger extensors and finger flexors;
• score > 10 < 30 on the Upper extremity Fugl Meyer AND active shoulder flexion of at least 30 degrees with device weight on affected arm;
• Ability to generate consistent, detectable EMG signal from the bicep/tricep upper arm and distal forearm flexor and extensor sensor sites with wrist in neutral, and fingers in neutral. At rest, achieve an EMG of 5 or below on myConfig (wrist and fingers in neutral and elbow extended); with gain at < 10 and boost <12, able to reach a threshold of 10 at both bicep and wrist flexors/extensors;
• a single stroke that is the cause of arm impairment, experienced >12 months ago; if there are additional asymptomatic lesions (as diagnosed by MRI), these subjects may also be included. Those with another symptomatic stroke in addition to the stroke causing arm impairment are excluded;
• score >70 on the Modified Mini Mental Status Examination;
• age >18< 85;
• > 6 months since previous functional or therapeutic use of an upper extremity myoelectric orthosis;
• Height >5'0";
• Weight >110< 250 lbs.;
• Forearm circumference (at widest part) <13 in.;
• Bicep circumference >9 <15 in.;
• Upper arm length >5.5 in.;
• Wrist thickness (anterior- posterior) <1.75 in.;
• ability to stand with minimal assistance

Exclusion Criteria:

• > 5 on a 0-10 Numeric Pain Rating Scale for pain in the paretic hand, arm or shoulder;
• > 3 on the Modified Ashworth Spasticity Scale in the paretic elbow, >2 at wrist or fingers;
• < 2.5 on the Alexander Apraxia scale; '
• history of neurological disorder other than stroke;
• change in anti-spasticity medications in the last 6 months, and/or receipt of botulinum toxin in the paretic UE in the previous 4 months;
• elbow contracture greater than 10 degrees;
• inability to passively extend fingers while wrist is in neutral;
• other conditions or physical/mental attributes that may undermine safety and/or full participation in the study;
• bilateral hemiparesis.