Repetitive facilitative exercise under continuous electrical stimulation for severe arm impairment after sub-acute stroke: a randomized controlled pilot study

Brain Inj. 2014;28(2):203-10. doi: 10.3109/02699052.2013.860472. Epub 2013 Dec 4.

Abstract

Objective: To investigate the effectiveness of repetitive facilitative exercise (RFE) under surface neuromuscular electrical stimulation (NMES) in patients with post-stroke hemiplegia.

Methods: This randomized, controlled, observer-blinded, pilot trial randomized 27 adults with severe arm impairment [Fugl-Meyer Arm scale (FMA) ≤ 20] due to stroke of 3-13 weeks duration into three groups and provided treatment on a 4-week, 40 minutes/day, 5 days/week schedule. The RFE-under-NMES group were given 100-150 repetitions of standardized movements of shoulder, elbow and wrist joints of their affected arm with concurrent low-amplitude NMES for each corresponding musculature. The RFE group was given the same exercise regimen but without NMES. The control group was treated with a conventional arm rehabilitation programme without NMES. FMA was assessed at baseline and 4 weeks.

Results: All 27 participants (nine in each group) completed the trial. At 4 weeks, the RFE-under-NMES group evidenced significantly greater improvement compared with the control group on the FMA (p = 0.003), but not with the RFE group (p = 0.092). The RFE group showed improvement compared with the control group, but it was not significant (p = 0.199).

Conclusions: RFE under NMES is feasible in clinical settings and may be more effective than conventional rehabilitation in lessening arm impairment after sub-acute stroke.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Arm / physiopathology*
  • Electric Stimulation Therapy* / methods
  • Exercise Therapy* / methods
  • Female
  • Hemiplegia / etiology
  • Hemiplegia / physiopathology*
  • Hemiplegia / rehabilitation
  • Humans
  • Male
  • Middle Aged
  • Pilot Projects
  • Recovery of Function
  • Severity of Illness Index
  • Stroke / complications
  • Stroke / physiopathology*
  • Stroke Rehabilitation
  • Time Factors
  • Treatment Outcome