Attempting to improve function and quality of life using the FTM Protocol: case report

Area of Science:

• Neurorehabilitation
• Biomedical Engineering
• Physical Therapy

Background:

• The Functional Tone Management (FTM) program combines repetitive task practice, stretching, and electrical stimulation with dynamic hand orthosis use.
• It aims to retrain grasp and release functions in patients with moderate upper extremity hemiparesis post-stroke.

Observation:

• A 44-year-old male with chronic stroke and moderate right upper extremity impairment participated in a 2-week FTM training program.
• Outcome measures included Fugl-Meyer Assessment (FMA), range of motion (ROM), Modified Ashworth Scale, Wolf Motor Function Test (WMFT), Motor Activity Log (MAL), and Stroke Impact Scale (SIS).

Findings:

• Immediate post-intervention gains were limited, with some improvements in active ROM and a slight decrease in tone.
• At 3-month follow-up, significant improvements were observed in WMFT (17% time reduction) and UE-FMA scores (17% improvement).
• Quality of life improved in several domains per SIS, though some areas like ADL/IADL and hand function saw decreases.

Implications:

• The FTM program demonstrated potential for modest functional gains and improved quality of life in a chronic stroke patient with moderate hemiparesis.
• Further investigation is warranted to establish the efficacy of FTM training for comparable patient populations.
• This case study highlights the potential of combining orthotics with targeted therapeutic interventions for upper extremity motor recovery.