Effect of Graded Repetitive Arm Supplementary Program (GRASP) combined with Functional Electrical Stimulation (FES) in subacute stroke with severe upper-extremity paresis: A case study

Abstract

The effect of Graded Repetitive Arm Supplementary Program (GRASP) combined with Functional Electrical Stimulation (FES) on stroke patients with severe upper limb paralysis was investigated in an ABA single case design. The method was the usual occupational therapy in phase A and the GRASP combined with FES in phase B, which was performed for 1 hour per day. Each period was set for 4 weeks. FES was applied to the proximal part of the upper limb where the paralysis was more severe. The results showed that the changes in upper limb function and real-world arm use exceeded the minimum clinical important difference in phase B. The patient was able to use the paralyzed hand as a support in daily life. The results suggest that the combination of GRASP and FES for severe upper limb paralysis may improve upper limb function and real-world arm use.