Long-term effectiveness of neuromuscular electrical stimulation for promoting motor recovery of the upper extremity after stroke

Objective. The primary aim of this study was to compare the predictive value of motor evoked potentials (MEPs) and early clinical assessment with regard to long-term hand motor recovery in patients with profound hemiplegia after stroke. Methods. The sample was an inception cohort of 39 stroke patients with an acute, ischemic, supratentorial stroke and an initial upper-extremity paralysis admitted to an academic hospital. Hand motor function recovery was defined at 26 weeks poststroke as a Fugl–Meyer Motor Assessment (FMA) hand score >3 points. The following prognostic factors were compared at week 1 and week 3 poststroke: motor functions as assessed by the FMA upper-extremity and lower-extremity subscores, and the presence of an MEP in the abductor digiti minimi and biceps brachii muscle. Results. Both the presence of an abductor digiti minimi–MEP and any motor recovery in the FMA upper-extremity subscore showed a positive predictive value of 1.00 at weeks 1 and 3. The FMA lower-extremity subscore showed the best negative predictive value (0.90; 95% CI 0.78-1.00 at week 1 and 0.95; 95% CI 0.87-1.00 at week 3). Conclusions. In stroke patients with an initial paralysis of the upper extremity the presence or absence of an MEP has similar predictive value compared with early clinical assessment with regard to long-term hand motor recovery.

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Electromyogram-Related Neuromuscular Electrical Stimulation for Restoring Wrist and Hand Movement in Poststroke Hemiplegia: A Systematic Review and Meta-Analysis

Neurorehabilitation and Neural Repair ◽

10.1177/1545968319826053 ◽

2019 ◽

Vol 33 (2) ◽

pp. 96-111 ◽

Cited By ~ 16

Author(s):

Katia Monte-Silva ◽

Daniele Piscitelli ◽

Nahid Norouzi-Gheidari ◽

Marc Aureli Pique Batalla ◽

Philippe Archambault ◽

...

Keyword(s):

Systematic Review ◽

Clinical Trials ◽

Electrical Stimulation ◽

Meta Analysis ◽

Neuromuscular Electrical Stimulation ◽

Structure And Function ◽

Motor Recovery ◽

Body Structure ◽

Short Term ◽

And Function

Background. Clinical trials have demonstrated some benefits of electromyogram-triggered/controlled neuromuscular electrical stimulation (EMG-NMES) on motor recovery of upper limb (UL) function in patients with stroke. However, EMG-NMES use in clinical practice is limited due to a lack of evidence supporting its effectiveness. Objective. To perform a systematic review and meta-analysis to determine the effects of EMG-NMES on stroke UL recovery based on each of the International Classification of Functioning, Disability, and Health (ICF) domains. Methods. Database searches identified clinical trials comparing the effect of EMG-NMES versus no treatment or another treatment on stroke upper extremity motor recovery. A meta-analysis was done for outcomes at each ICF domain (Body Structure and Function, Activity and Participation) at posttest (short-term) and follow-up periods. Subgroup analyses were conducted based on stroke chronicity (acute/subacute, chronic phases). Sensitivity analysis was done by removing studies rated as poor or fair quality (PEDro score <6). Results. Twenty-six studies (782 patients) met the inclusion criteria. Fifty percent of them were considered to be of high quality. The meta-analysis showed that EMG-NMES has a robust short-term effect on improving UL motor impairment in the Body Structure and Function domain. No evidence was found in favor of EMG-NMES for the Activity and Participation domain. EMG-NMES had a stronger effect for each ICF domain in chronic (≥3 months) compared to acute/subacute phases. Conclusion. EMG-NMES is effective in the short term in improving UL impairment in individuals with chronic stroke.

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Electrical stimulation and iterative learning control combined with real objects and simulated tasks to assist motor recovery in the upper extremity post-stroke

2014 IEEE 19th International Functional Electrical Stimulation Society Annual Conference (IFESS) ◽

10.1109/ifess.2014.7036741 ◽

2014 ◽

Cited By ~ 1

Author(s):

Ann-Marie Hughes ◽

Emma Hallewell ◽

Mustafa Kutlu ◽

Katie Meadmore ◽

Chris Freeman

Keyword(s):

Electrical Stimulation ◽

Upper Extremity ◽

Iterative Learning Control ◽

Learning Control ◽

Motor Recovery ◽

Iterative Learning ◽

Post Stroke ◽

Real Objects

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Dose-Response Relation Between Neuromuscular Electrical Stimulation and Upper-Extremity Function in Patients With Stroke

Stroke ◽

10.1161/strokeaha.109.574160 ◽

2010 ◽

Vol 41 (4) ◽

pp. 821-824 ◽

Cited By ~ 48

Author(s):

Shu-Shyuan Hsu ◽

Ming-Hsia Hu ◽

Yen-Ho Wang ◽

Ping-Keung Yip ◽

Jan-Wei Chiu ◽

...

Keyword(s):

Electrical Stimulation ◽

Upper Extremity ◽

Dose Response ◽

Neuromuscular Electrical Stimulation ◽

Extremity Function ◽

Upper Extremity Function

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Effects of Neuromuscular Electrical Stimulation on Hemiplegic Upper Limb of Stroke Survivors: A Meta-Analysis of Randomized Controlled Trials

10.21203/rs.2.19509/v1 ◽

2019 ◽

Author(s):

Wenyue Zhang ◽

Shuye Pei ◽

Juan Huang ◽

Yao Tang ◽

Huaidong Hu

Keyword(s):

Electrical Stimulation ◽

Randomized Controlled Trials ◽

Upper Extremity ◽

Upper Limb ◽

Meta Analysis ◽

Neuromuscular Electrical Stimulation ◽

Cochrane Library ◽

Control Group ◽

Controlled Trials ◽

Randomized Controlled

Abstract Background: Whether NMES helps the recovery of upper limb function in patients with hemiparesis has not been confirmed. We conducted this meta-analysis to examine the effectiveness of neuromuscular electrical stimulation (NMES) for upper limb hemiparesis after stroke.Methods: Data sources such as Pubmed, Embase and Cochrane library databases were searched for all relevant studies that were carried out before December 1, 2018.We selected the randomized controlled trials (RCTs) which included chronic and acute stroke patients with upper extremity dysfunction. Then the intervention group which applied NMES was compared with a control group without NMES. Results: A total of 16 RCTs involving 691 patients were discerned from 248 searched articles. According to the forest plot ,NMES had a significant benefit on FMA-ue scale(SMD=0.44,95%CI 0.13 to 0.74,P=0.006).Also, NMES was positive for ARAT(SMD=0.31,95%CI 0.05 to 0.58,P=0.019)and MAL-AOU(SMD=0.59,95%CI 0.15 to1.04,P=0.009),but not for wrist MAS(SMD=-0.12,95%CI -0.43 to 0.19,P=0.434) or BI(SMD=0.51,95%CI -0.65 to 1.66,P=0.392).Conclusion: NMES application has beneficial impacts on upper extremity motor function in patients with stroke. This study suggests that NMES ought to be applied as a beneficial rehabilitation means in improving the upper function.

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