Motor Training of Upper Extremity With Functional Electrical Stimulation in Early Stroke Rehabilitation

2008 ◽  
Vol 23 (2) ◽  
pp. 184-190 ◽  
Author(s):  
Sabine Mangold ◽  
Corina Schuster ◽  
Thierry Keller ◽  
Andrea Zimmermann-Schlatter ◽  
Thierry Ettlin
Keyword(s):  
Electrical Stimulation ◽  
Upper Extremity ◽  
Shoulder Pain ◽  
Functional Electrical Stimulation ◽  
Intervention Group ◽  
Passive Movement ◽  
Control Group ◽  
Motor Training ◽  
Stroke Patients ◽  
Subacute Stroke

Background. Functional electrical stimulation (FES) allows active exercises in stroke patients with upper extremity paralysis. Objective. To investigate the effect of motor training with FES on motor recovery in acute and subacute stroke patients with severe to complete arm and/or hand paralysis. Methods. For this pilot study, 23 acute and subacute stroke patients were randomly assigned to the intervention (n = 12) and control group (n = 11). Distributed over 4 weeks, FES training replaced 12 conventional training sessions in the intervention group. An Extended Barthel Index (EBI) subscore assessed the performance of activities of daily living (ADL). The Chedoke McMaster Stroke Assessment (CMSA) measured hand and arm function and shoulder pain. The Modified Ashworth Scale (MAS) assessed resistance to passive movement. Unblinded assessments were performed prior to and following the end of the training period. Results. The EBI subscore and CMSA arm score improved significantly in both groups. The CMSA hand function improved significantly in the FES group. Resistance to passive movement of finger and wrist flexors increased significantly in the FES group. Shoulder pain did not change significantly. None of the outcome measures, however, demonstrated significant gain differences between the groups. Conclusions. We did not find clear evidence for superiority or inferiority of FES. Our findings, and those of similar trials, suggest that the number of sessions should be at least doubled to test for superiority of FES in these highly impaired patients and approximately 50 participants would have to be assigned to each therapeutic intervention to find significant differences.

scholarly journals Physical Therapy and Rehabilitation Ideas for Inspiratory Muscle Training in Patients With Subacute Stroke

2021 ◽  
Vol 19 (4) ◽  
pp. 455-464
Author(s):  
Irma Ruslina Defi ◽  
◽  
Novitri Novitri ◽  
Ilin Nurina ◽  
◽  
...  
Keyword(s):  
Muscle Strength ◽  
Lung Function ◽  
Walking Speed ◽  
Intervention Group ◽  
Quadriceps Strength ◽  
Control Group ◽  
Muscle Training ◽  
Stroke Patients ◽  
Paretic Side ◽  
Subacute Stroke

Objectives: This study aimed to elucidate the outcome of an Inspiratory Muscle Training (IMT) rehabilitation intervention on the lung function, functional mobilization, balance, and peripheral muscle strength of the paretic side in patients with subacute stroke. Methods: This double-blind, randomized controlled trial study was conducted on patients with stable subacute stroke. For 8 weeks, the intervention group (n=16) received 40% intensity IMT while the control group (n=16) received 10% intensity IMT. We assessed the patients’ lung function (spirometer) before and after the intervention, as well as their pulmonary muscle strength (micro-respiratory pressure meter [RPM]), quadriceps strength (handheld dynamometer), grip strength (Jamar), walking speed (10-m walk test), balance (Berg Balance Scale [BBS]), and functional mobilization (sit-to-stand test). Results: There were significant differences between the intervention group and the control group after IMT for forced vital capacity (FVC)% (P<0.01; d=3.20), forced expiratory volume in the first second (FEV1)/FVC (P<0.001; d=2.55), FEV1% (P<0.001; d=5.10), walking speed (P<0.05; d=1.62), hand grip (P<0.001; d=2.45), quadriceps strength (P<0.001; d=4.18), functional mobilization (P<0.01; d=2.41), and maximal inspiratory mouth pressure (P<0.001; d=1.62), but no significant changes were seen in balance (P=0.304; d=0.57). Discussion: IMT improved lung function, functional mobilization, handgrip strength, and quadriceps strength on the paretic side of subacute stroke patients and is expected to improve functional status and allow the patient to participate in social activities. IMT exercise can be included in the rehabilitation program for subacute stroke patients.

scholarly journals Effectiveness of Contralaterally Controlled Functional Electrical Stimulation versus Neuromuscular Electrical Stimulation on Upper Limb Motor Functional Recovery in Subacute Stroke Patients: A Randomized Controlled Trial

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Songhua Huang ◽  
Peile Liu ◽  
Yinglun Chen ◽  
Beiyao Gao ◽  
Yingying Li ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Electrical Stimulation ◽  
Upper Limb ◽  
Functional Electrical Stimulation ◽  
Controlled Trial ◽  
Neuromuscular Electrical Stimulation ◽  
Stroke Patients ◽  
Randomized Controlled ◽  
Subacute Stroke ◽  
Extensor Carpi Radialis

Purpose. To compare the effectiveness of contralaterally controlled functional electrical stimulation (CCFES) versus neuromuscular electrical stimulation (NMES) on motor recovery of the upper limb in subacute stroke patients. Materials and Methods. Fifty patients within six months poststroke were randomly assigned to the CCFES group ( n = 25 ) and the NMES group ( n = 25 ). Both groups underwent routine rehabilitation plus 20-minute stimulation on wrist extensors per day, five days a week, for 3 weeks. Fugl-Meyer Assessment of upper extremity (FMA-UE), action research arm test (ARAT), Barthel Index (BI), and surface electromyography (sEMG) were assessed at baseline and end of intervention. Results. After a 3-week intervention, FMA-UE and BI increased in both groups ( p < 0.05 ). ARAT increased significantly only in the CCFES group ( p < 0.05 ). The changes of FMA-UE, ARAT, and BI in the CCFES group were not greater than those in the NMES group. The improvement in sEMG response of extensor carpi radialis by CCFES was greater than that by NMES ( p = 0.026 ). The cocontraction ratio (CCR) of flexor carpi radialis did not decrease in both groups. Conclusions. CCFES improved upper limb motor function, but did not show better treatment effect than NMES. CCFES significantly enhanced the sEMG response of paretic extensor carpi radialis compared with NMES, but did not decrease the cocontraction of antagonist.

scholarly journals The Combination of Softball Handling Exercise and ROM Increases Upper Extremity Muscle Strength in Non-Haemoragic Stroke Patients

2020 ◽  
Vol 4 (1) ◽  
pp. 29-37
Author(s):  
Ade Lestiani Limaretha ◽  
Mugi Hartoyo ◽  
Syamsul Arif
Keyword(s):  
Muscle Strength ◽  
Upper Extremity ◽  
Intervention Group ◽  
Wilcoxon Test ◽  
Control Group ◽  
P Value ◽  
Stroke Patients ◽  
Whitney Test ◽  
Mann Whitney Test ◽  
And Control

Background: Stroke is a brain tissues damage caused by blood supply disruption to the brain. Effects that often occurs in stroke patients is weakness in one side of the body, such as the upper extremity. Exercises to stimulate muscle hands strength can be a combination softball handling exercise and ROM. Purpose: This research aims to determine the effect of a combination softball handling exercise and ROM on muscle strength in non haemoragic stroke patients at Roemani Muhammadiyah Semarang Hospital.Methods: Type of research is Quasi Experiment with a non-rondomised control group pre-post test design. There were 32 respondents including in this research using purposive sampling to select the sample. The research data were analyzed using the Wilcoxon Test to determine the effect on the intervention group and control group, then tested using the Mann Whitney test to determine the effectiveness difference between a intervention group and control group.Results: the Wilcoxon Test showed that there was an effect of a combination softball handlingand ROM on muscle strength in non haemoragic stroke patients (p value 0.000), and there was an effect on the control group without intervention (p value 0.003). While the Mann Whitney test showed that the combination group was more effective in increasing the muscle strength p value = 0.001 (0.05).Conclusion: There is the effect of a combination of softball handling exercise and ROM on the strength of the extremity muscles over non haemoragic stroke pastients.

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