Effect of Functional Electrical Stimulation on Improving Upper Extremity Motor Function in Stroke Patients Revealed by fMRI: a Controlled Study

2015 ◽  
Vol 25 (3) ◽  
pp. 1
Author(s):  
Fangfang ZHENG ◽  
Huihua LIU ◽  
Tiebin YAN ◽  
Xiaokun JIN ◽  
Xiaohui DUAN ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Upper Extremity ◽  
Motor Function ◽  
Functional Electrical Stimulation ◽  
Controlled Study ◽  
Stroke Patients

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 Effectiveness of Functional Electrical Stimulation in Improving Clinical Outcomes in the Upper Arm following Stroke: A Systematic Review and Meta-Analysis

2015 ◽  
Vol 2015 ◽  
pp. 1-14 ◽  
Author(s):  
Amir K. Vafadar ◽  
Julie N. Côté ◽  
Philippe S. Archambault
Keyword(s):  
Electrical Stimulation ◽  
Motor Function ◽  
Functional Electrical Stimulation ◽  
Meta Analysis ◽  
Final Analysis ◽  
Stroke Patients ◽  
Upper Arm ◽  
Significant Difference ◽  
Evidence Database ◽  
Meta Analyses

Background.Different therapeutic methods are being used to prevent or decrease long-term impairments of the upper arm in stroke patients. Functional electrical stimulation (FES) is one of these methods, which aims to stimulate the nerves of the weakened muscles so that the resulting muscle contractions resemble those of a functional task.Objectives.The objective of this study was to review the evidence for the effect of FES on (1) shoulder subluxation, (2) pain, and (3) upper arm motor function in stroke patients, when added to conventional therapy.Methods.From the 727 retrieved articles, 10 (9 RCTs, 1 quasi-RCT) were selected for final analysis and were rated based on the PEDro (Physiotherapy Evidence Database) scores and the Sackett’s levels of evidence. A meta-analysis was performed for all three considered outcomes.Results.The results of the meta-analyses showed a significant difference in shoulder subluxation in experimental groups compared to control groups, only if FES was applied early after stroke. No effects were found on pain or motor function outcomes.Conclusion.FES can be used to prevent or reduce shoulder subluxation early after stroke. However, it should not be used to reduce pain or improve upper arm motor function after stroke.

scholarly journals Therapeutic Efficacy of Transcutaneous Electrical Nerve Stimulation Acupoints on Motor and Neural Recovery of the Affected Upper Extremity in Chronic Stroke: A Sham-Controlled Randomized Clinical Trial

Healthcare ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 614
Author(s):  
Reem M. Alwhaibi ◽  
Noha F. Mahmoud ◽  
Hoda M. Zakaria ◽  
Walaa M. Ragab ◽  
Nisreen N. Al Awaji ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Upper Extremity ◽  
Motor Function ◽  
Nerve Stimulation ◽  
Transcutaneous Electrical Nerve Stimulation ◽  
Chronic Stroke ◽  
Post Treatment ◽  
Motor Area ◽  
Stroke Patients ◽  
Electrical Nerve Stimulation

Inability to use the affected upper extremity (UE) in daily activities is a common complaint in stroke patients. The somatosensory system (central and peripheral) is essential for brain reorganization and plasticity. Neuromuscular electrical stimulation is considered an effective modality for improving UE function in stroke patients. The aim of the current study was to determine the therapeutic effects of transcutaneous electrical nerve stimulation (TENS) acupoints on cortical activity and the motor function of the affected UE in chronic stroke patients. Forty male and female patients diagnosed with stroke agreed to join the study. They were randomly assigned to group 1 (G1) and group 2 (G2). G1 received task-specific training (TST) and sham electrical stimulation while G2 received TST in addition to TENS acupoints. Session duration was 80 min. Both groups received 18 sessions for 6 successive weeks, 3 sessions per week. Evaluation was carried out before and after completion of the treatment program. Outcome measures used were the Fugl-Meyer Assessment of the upper extremity (FMA-UE) and the box and block test (BBT) as measures of the motor function of the affected UE. Brain activity of the motor area (C3) in the ipsilesional hemisphere was measured using a quantitative electroencephalogram (QEEG). The measured parameter was peak frequency. It was noted that the motor function of the affected UE improved significantly post-treatment in both groups, while no significant change was reported in the FMA-UE and BBT scores post-treatment in either G1 or G2. On the other hand, the activity of the motor area C3 improved significantly in G2 only, post-treatment, while G1 showed no significant improvement. There was also significant improvement in the activity of the motor area (C3) in G2 compared to G1 post-treatment. The results of the current study indicate that TST only or combined with TENS acupoints can be considered an effective method for improving motor function of the affected UE in chronic stroke patients, both being equally effective. However, TST combined with TENS acupoints proved better in improving brain plasticity in chronic stroke patients.

scholarly journals Effects of Neuromuscular Electrical Stimulation Combined with Repetitive Transcranial Magnetic Stimulation on Upper Limb Motor Function Rehabilitation in Stroke Patients with Hemiplegia

2022 ◽  
Vol 2022 ◽  
pp. 1-7
Author(s):  
Junqiu Du ◽  
Shouyong Wang ◽  
Yun Cheng ◽  
Jiang Xu ◽  
Xuejing Li ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Transcranial Magnetic Stimulation ◽  
Upper Extremity ◽  
Motor Function ◽  
Upper Limb ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Motor Nerve ◽  
Neuromuscular Electrical Stimulation ◽  
Stroke Patients

Objective. To investigate the effect of neuromuscular electrical stimulation (NMES) combined with repetitive transcranial magnetic stimulation (rTMS) on upper limb motor dysfunction in stroke patients with hemiplegia. Methods. A total of 240 stroke patients with hemiplegia who met the inclusion criteria were selected and randomly divided into 4 groups (60 cases in each group): control group, NMES group, rTMS group, and NMES + rTMS group. Before treatment and 4 weeks after treatment, we evaluated and compared the results including Fugl-Meyer assessment of upper extremity (FMA-UE) motor function, modified Barthel index (MBI), modified Ashworth scale (MAS), and motor nerve electrophysiological results among the 4 groups. Results. Before treatment, there was no significant difference in the scores of FMA-UE, MBI, MAS, and motor nerve electrophysiological indexes among the four groups, with comparability. Compared with those before treatment, the scores of the four groups were significantly increased and improved after treatment. And the score of the NMES + rTMS group was notably higher than those in the other three groups. Conclusion. NMES combined with rTMS can conspicuously improve the upper extremity motor function and activities of daily life of stroke patients with hemiplegia, which is worthy of clinical application and promotion.

scholarly journals A portable assist-as-need upper-extremity hybrid exoskeleton for FES-induced muscle fatigue reduction in stroke rehabilitation

2019 ◽  
Vol 1 (1) ◽  
Author(s):  
Ashley Stewart ◽  
Christopher Pretty ◽  
Xiaoqi Chen
Keyword(s):  
Electrical Stimulation ◽  
Muscle Fatigue ◽  
Upper Extremity ◽  
Functional Electrical Stimulation ◽  
Stroke Rehabilitation ◽  
Hybrid Control ◽  
Stroke Patients ◽  
Angle Error ◽  
Stimulation Control ◽  
Average Angle

Abstract Background Hybrid exoskeletons are a recent development which combine Functional Electrical Stimulation with actuators to improve both the mental and physical rehabilitation of stroke patients. Hybrid exoskeletons have been shown capable of reducing the weight of the actuator and improving movement precision compared to Functional Electrical Stimulation alone. However little attention has been given towards the ability of hybrid exoskeletons to reduce and manage Functional Electrical Stimulation induced fatigue or towards adapting to user ability. This work details the construction and testing of a novel assist-as-need upper-extremity hybrid exoskeleton which uses model-based Functional Electrical Stimulation control to delay Functional Electrical Stimulation induced muscle fatigue. The hybrid control is compared with Functional Electrical Stimulation only control on a healthy subject. Results The hybrid system produced 24° less average angle error and 13.2° less Root Mean Square Error, than Functional Electrical Stimulation on its own and showed a reduction in Functional Electrical Stimulation induced fatigue. Conclusion As far as the authors are aware, this is the study which provides evidence of the advantages of hybrid exoskeletons compared to use of Functional Electrical Stimulation on its own with regards to the delay of Functional Electrical Stimulation induced muscle fatigue.

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