Orthotic functional electrical stimulation following botulinum toxin for a young adult with severe hand impairment due to childhood stroke

This case report describes the outcomes of a task-specific training protocol using functional electrical stimulation for a young adult with severe hand impairment from a childhood stroke who had a history of tendon transfer and a recent botulinum toxin injection. A 22-year-old female who had a hemorrhagic stroke at age 5, a tendon transfer at 18, and a botulinum toxin injection 6 weeks before study entry, participated in a home- and clinic-based task-specific training program using a functional electrical stimulation orthosis. Training was 30-90 minutes per day, 4 days per week, for 4 weeks. Stroke-specific outcomes were measured before and after intervention. Increases occurred in the following scores: Action Research Arm Test, Stroke Impact Scale Hand Function Domain, and Canadian Occupational Performance Measure. A task-specific training protocol using orthotic functional electrical stimulation appears to have increased hand function and quality of life for an adult with chronic, childhood-onset stroke. To our knowledge, this is the first study to investigate the efficacy of functional electrical stimulation for such an individual.