Effect of passive limb activation by Functional Electrical Stimulation on wheelchair driving in patients with unilateral spatial neglect: A case study

Background/Objective

Limb activation is one of the behavioural interventions to improve unilateral spatial neglect (USN). However, the effect of passive limb activation on activities of daily living (ADL) is not clear. This study examined the effect of passive limb activation by functional electrical stimulation (FES) on wheelchair driving for patients with USN, and to discuss the possibility of application of this treatment to occupational therapy.

Methods

A single subject design-baseline-intervention-baseline (ABA′), was applied to 2 stroke patients with USN. Phase A and A′ consisted of the wheelchair driving task only. Phase B consisted of the wheelchair driving task with FES. Each phase lasted for 2 weeks. The wheelchair driving task was maneuvering on a square passage in the clockwise and counter clockwise conditions for 8 minutes respectively, and four obstacles were set at each side. FES was applied to the affected forearm extensor muscles. Assessor recorded: 1) The distance participants drove wheelchair for 8 minutes, and 2) The number of collisions with obstacles and the wall, for 10 days.

Results

For one participant, the distance of maneuvering significantly increased in phase B (p < .05.), and USN on the cognitive test in the extrapersonal space indicated a tendency to improve after phase B.

Conclusion

Passive limb activation by FES improved wheelchair driving and cognitive performance for patients with USN. It can be used with instruction from occupational therapists to enhance the performance on ADL.