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Strengthening Hemiparetic Patients with Biodex Multi-Joint System
The Upper Extremity Hemiparetic Attachments combine traditional functional task activities with dynamic-resistance training (power training) of isolated joint, and eccentric and concentric training on the Biodex Multi-Joint System.  These specialized attachments accommodate the impaired grasp associated with hemiplegia. 

The Biodex dynamometer affords control over many relevant training parameters. The end result:

• Positive functional outcomes
• Increased strength and joint power
• Improved reflex modulation
• Better retention of treatment effects
• No risk of exacerbating spasticity, joint pain or injury

Case History

A 65-year-old right-hand dominant female presented to a target research program at the Neural Control of Movement Laboratory, Palo Alto VA Research and Development Center 16 weeks following clipping of an unruptured aneurysm with consequent right hemiparesis.

Patient received 49 days of acute rehabilitation (according to CARF guidelines) of which 29 were acute inpatient rehabilitation days and ten were spent in an outpatient day rehabilitation program. The comprehensive rehabilitation program included physical therapy, occupational therapy and speech therapy. All disciplines targeted different levels of the International Classification of Functioning, Disability, and Health (ICF) including: body structure/function, activity, and participation.

The Stroke Impact Scale score reporting her perspective indicated she had recovered from her stroke only 50%. The hybrid resistance training-functional task practice intervention, detailed in the referenced research study, was delivered three times per week for six weeks, with each session lasting 75 minutes.

Outcome:

The subject revealed marked improvements in isometric and dynamic force production in five key upper-extremity actions: elbow flexion, elbow extension, shoulder flexion, shoulder abduction and shoulder external rotation. Strength gains were accompanied by increased EMG activation immediately post intervention and by a combination of increased activation and apparent hypertrophic effects at six month follow up. Marked improvements were noted in all clinical and functional measures.

Discussion:

Improvements in strength and positive outcome effects at the physiological, clinical and function levels were observed in this subject following the experimental hybrid upper extremity rehabilitation intervention described. Importantly, no deleterious effects were observed including exacerbation of spasticity or musculoskeletal compromise.  Observations of improved EMG activation in this case study suggest that improvements in motor activation underlie these strength gains and can likely be attributed to working at a high-intensity level.

Download the complete Research Study for program and protocol >>