Neuromuscular Electrical Stimulation Therapy Effects on the Functional and Motor Recovery of the Upper Extremity in Patients after Stroke: A Randomized Controlled Trial

Abstract

Introduction: This study aimed to investigate the effectiveness of passive neuromuscular electrical stimulation (NMES) combined with conventional rehabilitation program (CRP) in stroke patients in terms of enhancing the motor and functional recovery of the upper extremity (UE), improving spasticity, pain, and ability to engage in daily activities. Methods: A total of 30 patients with hemiplegia were randomly distributed in two groups. The study group included 15 patients who received a CRP plus passive NMES applied to shoulder girdle muscles and wrist extensors. The control group included 15 patients who received only CRP. Assessments of the UE impairment were made at enrolment, midtreatment, end of treatment, and 2 months thereafter. Follow-up parameters were the Brunnstrom stage, UE parts of the Fugl-Meyer Assessment (FMA), Barthel index, visual analog scale (VAS) score, and Modified Ashworth scale (MAS). Results: Statistically significant improvements were found in the Brunnstrom stages of the upper extremities and hands, FMA, and VAS score of the study group at the end of therapy and after 2 months. The FMA overall score improved significantly in the control group at the completion of treatment and after 2 months. MAS scores were higher in the control group at the end of therapy and 2 months afterward, but values did not significantly differ between groups. Conclusion: CRP plus passive NMES treatment applied to shoulder girdle muscles and wrist extensors seems to be no better than CRP alone, but passive NMES therapy is suggested to be used as an adjunct to neurological rehabilitation as it contributes to functional and motor recovery.