AUTHOR=Popovic Milos R. , Zivanovic Vera , Valiante Taufik A. 

TITLE=Restoration of Upper Limb Function in an Individual with Cervical Spondylotic Myelopathy using Functional Electrical Stimulation Therapy: A Case Study

JOURNAL=Frontiers in Neurology

VOLUME=Volume 7 - 2016

YEAR=2016

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2016.00081

DOI=10.3389/fneur.2016.00081

ISSN=1664-2295

ABSTRACT=Non-traumatic spinal cord pathology is responsible for 25 to 52% of all spinal cord lesions. Studies have revealed that spinal stenosis accounts for 16 to 21% of spinal cord injury (SCI) admissions. Impaired grips as well as slow unskilled hand and finger movements are the most common complaints in patients with spinal cord disorders such as myelopathy secondary to cervical spondylosis. Motivated by our prior successful clinical trials, including two randomized control trials showing that functional electrical stimulation therapy (FEST) can restore voluntary reaching and/or grasping function in people with stroke and traumatic SCI, this study was designed to examine changes in the upper limb function following FEST in a patient who suffered loss of hand function due to myelopathy secondary to cervical spondylosis. The participant was a 61 year old male who had C3-C7 posterior laminectomy and instrumented fusion for cervical myelopathy. The participant presented with progressive right hand weakness that resulted in his inability to voluntary open and close the hand, and to manipulate objects unilaterally with his right hand. The participant was enrolled in the study approximately 12 months following surgical intervention. Participant was assessed using Toronto Rehabilitation Institute Hand Function Test (TRI-HFT), Action Research Arm Test (ARAT) and Functional Independence Measure (FIM), and Spinal Cord Independence Measure (SCIM). The pre-post differences in scores on all measures clearly demonstrate improvement in voluntary hand function following 15 one-hour FEST sessions. The changes observed were meaningful and have resulted in substantial improvement in performance of activities of daily living. These results provide preliminary evidence that FEST has a potential to improve upper limb function in patients with non-traumatic SCI, such as myelopathy secondary to cervical spondylosis.