Feasibility study of a combined treatment of electromyography-triggered neuromuscular stimulation and mirror therapy in stroke patients: A randomized crossover trial

• Published in: NeuroRehabilitation (Reading, Mass.) Vol. 34; no. 2; pp. 235 - 244
• Main Authors: Kojima, Kosuke, Ikuno, Koki, Morii, Yuta, Tokuhisa, Kentaro, Morimoto, Shigeru, Shomoto, Koji
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.01.2014
• Subjects: Adult; Aged; Combined Modality Therapy - methods; Cross-Over Studies; Electric Stimulation Therapy - methods; Electromyography - methods; Feasibility Studies; Female; Functional Laterality - physiology; Hemiplegia - etiology; Hemiplegia - rehabilitation; Humans; Male; Middle Aged; Outcome Assessment (Health Care); Physical Therapy Modalities; Pilot Projects; Range of Motion, Articular - physiology; Recovery of Function; Stroke - complications; Stroke Rehabilitation; Treatment Outcome; Upper Extremity; Electromyography-triggered neuromuscular stimulation; stroke rehabilitation; hemiplegia; mirror therapy; upper extremity
• ISSN: 1053-8135; 1878-6448
• DOI: 10.3233/NRE-131038

Background: Mirror therapy (MT) and electromyography-triggered neuromuscular stimulation (ETMS) are both effective treatments for impaired upper limbs following stroke. A combination of these two treatments (ETMS-MT) may result in greater gain than either treatment alone. Objectives: The feasibility and possible effects of ETMS-MT upon upper extremity function were investigated in stroke patients. Methods: Thirteen post-acute stroke patients were randomly assigned to an immediate ETMS-MT group or a delayed ETMS-MT group and then underwent an 8-week training program. The immediate ETMS-MT group received ETMS-MT in addition to physical and occupational therapy (PT+OT) for 4 weeks. They then received only PT+OT for the next 4 weeks. In the delayed ETMS-MT group, interventions were provided in the reverse order. The main outcome measure was the Fugl-Meyer Assessment (FMA). Results: The immediate ETMS-MT group showed significantly greater gain in FMA in the first 4 weeks. The delayed ETMS-MT group showed significantly greater gain in active range of motion during the latter 4 weeks. No adverse effects were reported following ETMS-MT. Conclusion: ETMS-MT might be as effective as independent MT or ETMS without causing any side effects. Future research should focus upon the direct comparisons between independent and combined interventions.