Upper limb recovery in early acute phase stroke survivors by coupled EMG-triggered and cyclic neuromuscular electrical stimulation

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.

Download Full-text

Repetitive peripheral magnetic stimulation improves severe upper limb paresis in early acute phase stroke survivors

Neurorehabilitation ◽

10.3233/nre-203085 ◽

2020 ◽

Vol 46 (4) ◽

pp. 569-575

Author(s):

Shigeru Obayashi ◽

Rina Takahashi

Keyword(s):

Acute Phase ◽

Upper Limb ◽

Magnetic Stimulation ◽

Stroke Survivors ◽

Upper Limb Paresis

Download Full-text

Efficacy of a Hybrid Upper Limb Neuromuscular Electrical Stimulation System in Lessening Selected Impairments and Dysfunctions Consequent to Cerebral Damage

Neurorehabilitation and Neural Repair ◽

10.1177/154596839801200205 ◽

1998 ◽

Vol 12 (2) ◽

pp. 73-79 ◽

Cited By ~ 5

Author(s):

G. Alon ◽

A. Dar ◽

D. Katz-Behiri ◽

H. Weingarden ◽

R. Nathan

Keyword(s):

Electrical Stimulation ◽

Upper Limb ◽

Neuromuscular Electrical Stimulation ◽

Cerebral Damage ◽

Stimulation System

Download Full-text

Improvement and Neuroplasticity after Combined Rehabilitation to Forced Grasping

Case Reports in Neurological Medicine ◽

10.1155/2017/1028390 ◽

2017 ◽

Vol 2017 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Michiko Arima ◽

Atsuko Ogata ◽

Kazumi Kawahira ◽

Megumi Shimodozono

Keyword(s):

Electrical Stimulation ◽

Upper Limb ◽

Near Infrared ◽

Botulinum Toxin Type A ◽

Combined Treatment ◽

Neuromuscular Electrical Stimulation ◽

Botulinum Toxin Type ◽

Functional Improvement ◽

Upper Limb Function ◽

Flexor Muscles

The grasp reflex is a distressing symptom but the need to treat or suppress it has rarely been discussed in the literature. We report the case of a 17-year-old man who had suffered cerebral infarction of the right putamen and temporal lobe 10 years previously. Forced grasping of the hemiparetic left upper limb was improved after a unique combined treatment. Botulinum toxin type A (BTX-A) was first injected into the left biceps, wrist flexor muscles, and finger flexor muscles. Forced grasping was reduced along with spasticity of the upper limb. In addition, repetitive facilitative exercise and object-related training were performed under low-amplitude continuous neuromuscular electrical stimulation. Since this 2-week treatment improved upper limb function, we compared brain activities, as measured by near-infrared spectroscopy during finger pinching, before and after the combined treatment. Brain activities in the ipsilesional sensorimotor cortex (SMC) and medial frontal cortex (MFC) during pinching under electrical stimulation after treatment were greater than those before. The results suggest that training under electrical stimulation after BTX-A treatment may modulate the activities of the ipsilesional SMC and MFC and lead to functional improvement of the affected upper limb with forced grasping.

Download Full-text