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Effect of Force-Feedback Treatments in Patients with Chronic Motor Deficits After a Stroke

Bourbonnais, Daniel PhD, OT; Bilodeau, Suzie MA, OT; Lepage, Yves PhD; Beaudoin, Nicole MD, FRCP; Gravel, Denis PhD, PT; Forget, Robert PhD, PT

American Journal of Physical Medicine & Rehabilitation: December 2002 - Volume 81 - Issue 12 - p 890-897
Research Article: Stroke

Bourbonnais D, Bilodeau S, Lepage Y, Beaudoin N, Gravel D, Forget R: Effect of force-feedback treatments in patients with chronic motor deficits after a stroke. Am J Phys Med Rehabil 2002;81:890–897.

Objective To assess the effects a motor reeducation approach based on static dynamometers used to provide feedback on the force produced.

Design The study design was a single-blind, randomized, controlled trial. Chronic stroke subjects participated in a 6-wk, thrice-weekly, force-feedback program of either the upper paretic limb (n = 13) or the lower paretic limb (n = 12). Baseline and postintervention assessments of the performance of both the upper and the lower limb were measured for each subject, the untreated paretic limb of each group serving as a control for the other group.

Results With the exception of the handgrip force, strength measurements of the treated limb increased after completion of the treatment. The outcome measurements of the upper limb of the subjects included in the upper paretic limb were not significantly different after treatment from those measured in the lower paretic limb. In contrast, gait velocity and the distance walked in 2 min increased after treatment in the lower paretic limb as compared with the upper paretic limb, whereas the scores in the Fugl-Meyer test for the lower limb and the timed up-and-go test did not increase for either group after treatment.

Conclusion The results indicate that treatment of the lower limb based on force feedback produces an improvement of gait velocity.

From the Institut de réadaptation de Montréal (DB, SB, NB, DG, RF) and the École de réadaptation (DB, DG, RF) and Département de mathématiques et statistique (YL), Université de Montréal, Montréal, Québec, Canada.

Supported by the Medical Research Council of Canada and Fonds de la Recherche en Santé du Québec.

Presented at the Second World Congress in Neurological Rehabilitation, Toronto, Canada, April 1998; the Entretiens de l’Institut de Garches, Paris, France, November 1999; and the Second Pan-Pacific Conference on Rehabilitation and Neurological Rehabilitation, Hong-Kong, August 2000.

All correspondence and requests for reprints should be addressed to Daniel Bourbonnais, PhD, OT, Centre de recherche interdisciplinaire en réadaptation, Institut de réadaptation de Montréal, 6300 Darlington, Montréal, Québec, Canada H3S 2J4.

© 2002 Lippincott Williams & Wilkins, Inc.