Upper-Limb Recovery after Stroke: A Randomized Controlled Trial Comparing EMG-Triggered, Cyclic, and Sensory Electrical Stimulation
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- Case Western Reserve University
- Cleveland FES Center
- Akron General Medical Center
- Northeastern Ohio Universities College of Medicine
Background and 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 patients with upper-limb hemiplegia. Methods. 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. All groups exhibited significant improvement of 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.
- electrical stimulation, function, recovery, stroke