Effectiveness of hybrid assistive neuromuscular dynamic stimulation therapy in patients with subacute stroke: A randomized controlled pilot trial

Keiichiro Shindo, Toshiyuki Fujiwara, Joji Hara, Hideki Oba, Fujiko Hotta, Tetsuya Tsuji, Kimitaka Hase, Meigen Liu

Research output: Contribution to journalArticle

31 Citations (Scopus)


Background and objective. Hybrid assistive neuromuscular dynamic stimulation (HANDS) therapy was devised to facilitate the use of the hemiparetic upper extremity in daily life by combining assistive neuromuscular electrical stimulation, referred to as the integrated volitional electrical stimulator (IVES), with a splint. The aim of this study is to assess the effectiveness of HANDS therapy for patients with subacute stroke. Methods. The participants were 24 inpatients receiving rehabilitation for hemiparetic stroke within 60 days of onset. Entry criteria included inability to individuate finger extension. Patients were randomly assigned to 2 groups. The HANDS group (n = 12) used the IVES combined with a wrist splint for 8 hours a day for 3 weeks, and the control group (n = 12) wore a wrist splint alone. All patients received the same daily dose and length of standard poststroke multidisciplinary rehabilitation. Outcome measures were the upper extremity portion of the Fugl-Meyer Assessment (FMA), Action Research Arm Test (ARAT), and Motor Activity Log-14 (MAL). Results. In all, 10 patients in each group completed the interventions. Compared with the control group, the HANDS group showed significantly greater gains in distal (wrist/hand) portion of the FMA (P <.01) and improvement of the ARAT (P <.05). The gains in the MAL did not differ. No adverse effects occurred and the HANDS therapy was well accepted. Conclusion. HANDS therapy in addition to conventional therapy may improve hand function in patients with moderate to severe hand impairment during early rehabilitation.

Original languageEnglish
Pages (from-to)830-837
Number of pages8
JournalNeurorehabilitation and Neural Repair
Issue number9
Publication statusPublished - 2011 Nov 1



  • clinical controlled trial
  • electrical stimulation
  • hemiparesis
  • rehabilitation
  • stroke
  • upper extremity function

ASJC Scopus subject areas

  • Rehabilitation
  • Neurology
  • Clinical Neurology

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