Date Presented 03/28/20
Stroke-induced arm weakness is a leading cause of worldwide disability. OT practitioners commonly employ this modality, but it is unclear which type of electrical stimulation works best for people with stroke-induced weakness. This study compared the efficacy of three types of electrical stimulation for people zero to six months poststroke. We found that all three types of stimulation worked equally well.
Primary Author and Speaker: Stephen Page
Contributing Authors: John Chae, Richard Wilson
PURPOSE: This study compared the effect of cyclic neuromuscular electrical stimulation (NMES), electromyographically (EMG)-triggered NMES, and sensory stimulation on motor impairment and activity limitations in participants with upper-limb hemiplegia who were 0-6 months post stroke.
METHOD: This was a multicenter, single-blind, multiarm parallel-group study of nonhospitalized hemiplegic stroke survivors within 6 months of stroke. A total of 122 individuals were randomized to receive either cyclic NMES, EMG-triggered NMES, or sensory stimulation twice every weekday in 40-minute sessions, over an 8 week-period. Patients were followed for 6 months after treatment concluded.
RESULTS: There were significant increases in the Fugl-Meyer Assessment [F(1, 111) = 92.6, P < .001], FMA Wrist and Hand [F(1, 111) = 66.7, P < .001], and modified Arm Motor Ability Test [mAMAT; time effect: F(1, 111) = 91.0, P < .001] for all 3 groups. There was no significant difference in the improvement among groups in the FMA [F(2, 384) = 0.2, P = .83], FMA Wrist and Hand [F(2, 384) = 0.4, P = .70], or the mAMAT [F(2, 379) = 1.2, P = .31].
CONCLUSIONS: Impact Statement: All groups exhibited significant improvement in upper extremity impairment and functional limitation with electrical stimulation therapy applied within 6 months of stroke. Improvements were likely a result of spontaneous recovery. There was no difference based on the type of electrical stimulation that was administered
References
Wilson, R.D., Page, S.J., Delahanty, M., Knutson, J.S., Gunzler, D.D., Sheffler, L., & Chae J. (2016). Upper-Limb Recovery After Stroke: A Randomized Controlled Trial Comparing EMG-Triggered, Cyclic, and Sensory Electrical Stimulation. Neurorehabilitation and Neural Repair.;30 (10):978-987. DOI: 10.1177/1545968316650278.
Gabr, U., Levine, P., & Page, S.J. (2005). Home-based electromyography-triggered stimulation in chronic stroke. Clinical Rehabilitation, 19(7):737-745. DOI: 10.1191/0269215505cr909oa
