Effects of a 12-hour neuromuscular electrical stimulation treatment program on the recovery of upper extremity function in sub-acute stroke patients: a randomized controlled pilot trial

[Purpose] This study investigated the effects of a 12-hour neuromuscular electrical stimulation program in the evening hours on upper extremity function in sub-acute stroke patients. [Subjects and Methods] Forty-five subjects were randomized to one of three groups: 12-hour neuromuscular electrical s...

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Published inJournal of Physical Therapy Science Vol. 27; no. 7; pp. 2327 - 2331
Main Authors Wang, Dao-Qing, Sun, Qiang-San, Liu, Ben-Ling, Cui, Bao-Juan, Zhang, Qi, Sun, Min, Qiu, Jian-Qing, Zeng, Fan-Shuo, Huang, Lai-Gang
Format Journal Article
LanguageEnglish
Published Japan The Society of Physical Therapy Science 2015
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ISSN0915-5287
2187-5626
DOI10.1589/jpts.27.2327

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Abstract [Purpose] This study investigated the effects of a 12-hour neuromuscular electrical stimulation program in the evening hours on upper extremity function in sub-acute stroke patients. [Subjects and Methods] Forty-five subjects were randomized to one of three groups: 12-hour neuromuscular electrical stimulation group (n=15), which received 12 hours of neuromuscular electrical stimulation and conventional rehabilitation for the affected upper extremity; neuromuscular electrical stimulation group (n=15), which received 30 min of neuromuscular electrical stimulation and conventional rehabilitation; and control group (n=15), which received conventional rehabilitation only. The Fugl-Meyer assessment, Action Research Arm Test, and modified Ashworth scale were used to evaluate the effects before and after intervention, and 4 weeks later. [Results] The improvement in the distal (wrist-hand) components of the Fugl-Meyer assessment and Action Research Arm Test in the 12-hour neuromuscular electrical stimulation group was more significant than that in the neuromuscular electrical stimulation group. No significant difference was found between the two groups in the proximal component (shoulder-elbow) of the Fugl-Meyer assessment. [Conclusion] The 12-hour neuromuscular electrical stimulation group achieved better improvement in upper extremity motor function, especially in the wrist-hand function. This alternative therapeutic approach is easily applicable and can be used in stroke patients during rest or sleep.
AbstractList [Purpose] This study investigated the effects of a 12-hour neuromuscular electrical stimulation program in the evening hours on upper extremity function in sub-acute stroke patients. [Subjects and Methods] Forty-five subjects were randomized to one of three groups: 12-hour neuromuscular electrical stimulation group (n=15), which received 12 hours of neuromuscular electrical stimulation and conventional rehabilitation for the affected upper extremity; neuromuscular electrical stimulation group (n=15), which received 30 min of neuromuscular electrical stimulation and conventional rehabilitation; and control group (n=15), which received conventional rehabilitation only. The Fugl-Meyer assessment, Action Research Arm Test, and modified Ashworth scale were used to evaluate the effects before and after intervention, and 4 weeks later. [Results] The improvement in the distal (wrist-hand) components of the Fugl-Meyer assessment and Action Research Arm Test in the 12-hour neuromuscular electrical stimulation group was more significant than that in the neuromuscular electrical stimulation group. No significant difference was found between the two groups in the proximal component (shoulder-elbow) of the Fugl-Meyer assessment. [Conclusion] The 12-hour neuromuscular electrical stimulation group achieved better improvement in upper extremity motor function, especially in the wrist-hand function. This alternative therapeutic approach is easily applicable and can be used in stroke patients during rest or sleep.
[Purpose] This study investigated the effects of a 12-hour neuromuscular electrical stimulation program in the evening hours on upper extremity function in sub-acute stroke patients. [Subjects and Methods] Forty-five subjects were randomized to one of three groups: 12-hour neuromuscular electrical stimulation group (n=15), which received 12 hours of neuromuscular electrical stimulation and conventional rehabilitation for the affected upper extremity; neuromuscular electrical stimulation group (n=15), which received 30 min of neuromuscular electrical stimulation and conventional rehabilitation; and control group (n=15), which received conventional rehabilitation only. The Fugl-Meyer assessment, Action Research Arm Test, and modified Ashworth scale were used to evaluate the effects before and after intervention, and 4 weeks later. [Results] The improvement in the distal (wrist-hand) components of the Fugl-Meyer assessment and Action Research Arm Test in the 12-hour neuromuscular electrical stimulation group was more significant than that in the neuromuscular electrical stimulation group. No significant difference was found between the two groups in the proximal component (shoulder-elbow) of the Fugl-Meyer assessment. [Conclusion] The 12-hour neuromuscular electrical stimulation group achieved better improvement in upper extremity motor function, especially in the wrist-hand function. This alternative therapeutic approach is easily applicable and can be used in stroke patients during rest or sleep.[Purpose] This study investigated the effects of a 12-hour neuromuscular electrical stimulation program in the evening hours on upper extremity function in sub-acute stroke patients. [Subjects and Methods] Forty-five subjects were randomized to one of three groups: 12-hour neuromuscular electrical stimulation group (n=15), which received 12 hours of neuromuscular electrical stimulation and conventional rehabilitation for the affected upper extremity; neuromuscular electrical stimulation group (n=15), which received 30 min of neuromuscular electrical stimulation and conventional rehabilitation; and control group (n=15), which received conventional rehabilitation only. The Fugl-Meyer assessment, Action Research Arm Test, and modified Ashworth scale were used to evaluate the effects before and after intervention, and 4 weeks later. [Results] The improvement in the distal (wrist-hand) components of the Fugl-Meyer assessment and Action Research Arm Test in the 12-hour neuromuscular electrical stimulation group was more significant than that in the neuromuscular electrical stimulation group. No significant difference was found between the two groups in the proximal component (shoulder-elbow) of the Fugl-Meyer assessment. [Conclusion] The 12-hour neuromuscular electrical stimulation group achieved better improvement in upper extremity motor function, especially in the wrist-hand function. This alternative therapeutic approach is easily applicable and can be used in stroke patients during rest or sleep.
[Purpose] This study investigated the effects of a 12-hour neuromuscular electrical stimulation program in the evening hours on upper extremity function in sub-acute stroke patients. [Subjects and Methods] Forty-five subjects were randomized to one of three groups: 12-hour neuromuscular electrical stimulation group (n=15), which received 12 hours of neuromuscular electrical stimulation and conventional rehabilitation for the affected upper extremity; neuromuscular electrical stimulation group (n=15), which received 30 min of neuromuscular electrical stimulation and conventional rehabilitation; and control group (n=15), which received conventional rehabilitation only. The Fugl-Meyer assessment, Action Research Arm Test, and modified Ashworth scale were used to evaluate the effects before and after intervention, and 4 weeks later. [Results] The improvement in the distal (wrist-hand) components of the Fugl-Meyer assessment and Action Research Arm Test in the 12-hour neuromuscular electrical stimulation group was more significant than that in the neuromuscular electrical stimulation group. No significant difference was found between the two groups in the proximal component (shoulder-elbow) of the Fugl-Meyer assessment. [Conclusion] The 12-hour neuromuscular electrical stimulation group achieved better improvement in upper extremity motor function, especially in the wrist-hand function. This alternative therapeutic approach is easily applicable and can be used in stroke patients during rest or sleep.
[Abstract.] [Purpose] This study investigated the effects of a 12-hour neuromuscular electrical stimulation program in the evening hours on upper extremity function in sub-acute stroke patients. [Subjects and Methods] Forty-five subjects were randomized to one of three groups: 12-hour neuromuscular electrical stimulation group (n=15), which received 12 hours of neuromuscular electrical stimulation and conventional rehabilitation for the affected upper extremity; neuromuscular electrical stimulation group (n=15), which received 30 min of neuromuscular electrical stimulation and conventional rehabilitation; and control group (n=15), which received conventional rehabilitation only. The Fugl-Meyer assessment, Action Research Arm Test, and modified Ashworth scale were used to evaluate the effects before and after intervention, and 4 weeks later. [Results] The improvement in the distal (wrist-hand) components of the Fugl-Meyer assessment and Action Research Arm Test in the 12-hour neuromuscular electrical stimulation group was more significant than that in the neuromuscular electrical stimulation group. No significant difference was found between the two groups in the proximal component (shoulder-elbow) of the Fugl-Meyer assessment. [Conclusion] The 12-hour neuromuscular electrical stimulation group achieved better improvement in upper extremity motor function, especially in the wrist-hand function. This alternative therapeutic approach is easily applicable and can be used in stroke patients during rest or sleep.
Author Huang, Lai-Gang
Wang, Dao-Qing
Zhang, Qi
Zeng, Fan-Shuo
Sun, Qiang-San
Cui, Bao-Juan
Liu, Ben-Ling
Sun, Min
Qiu, Jian-Qing
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  fullname: Sun, Qiang-San
  organization: Department of Rehabilitation, The Second Hospital of Shandong University, Shandong Univeristy: 247 Beiyuan street, Jinan 250033, China
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  fullname: Liu, Ben-Ling
  organization: Department of Rehabilitation, The Second Hospital of Shandong University, Shandong Univeristy: 247 Beiyuan street, Jinan 250033, China
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  fullname: Cui, Bao-Juan
  organization: Department of Rehabilitation, The Second Hospital of Shandong University, Shandong Univeristy: 247 Beiyuan street, Jinan 250033, China
– sequence: 1
  fullname: Zhang, Qi
  organization: Department of Rehabilitation, The Second Hospital of Shandong University, Shandong Univeristy: 247 Beiyuan street, Jinan 250033, China
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  organization: Department of Rehabilitation, The Second Hospital of Shandong University, Shandong Univeristy: 247 Beiyuan street, Jinan 250033, China
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  organization: Department of Obstetrics and Gynecology, The Second Hospital of Shandong University, Shandong Univeristy, China
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  fullname: Zeng, Fan-Shuo
  organization: Department of Rehabilitation, The Second Hospital of Shandong University, Shandong Univeristy: 247 Beiyuan street, Jinan 250033, China
– sequence: 1
  fullname: Huang, Lai-Gang
  organization: Department of Rehabilitation, The Second Hospital of Shandong University, Shandong Univeristy: 247 Beiyuan street, Jinan 250033, China
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10.1152/jn.1996.75.5.2144
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10.2340/16501977-0941
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Keywords Stroke
Upper extremity function
Neuromuscular electrical stimulation
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References 18) Noma T, Matsumoto S, Shimodozono M, et al.: Novel neuromuscular electrical stimulation system for the upper limbs in chronic stroke patients: a feasibility study. Am J Phys Med Rehabil, 2014, 93: 503–510.
8) de Kroon JR, Ijzerman MJ, Chae J, et al.: Relation between stimulation characteristics and clinical outcome in studies using electrical stimulation to improve motor control of the upper extremity in stroke. J Rehabil Med, 2005, 37: 65–74.
13) Nudo RJ, Milliken GW: Reorganization of movement representations in primary motor cortex following focal ischemic infarcts in adult squirrel monkeys. J Neurophysiol, 1996, 75: 2144–2149.
11) Peurala SH, Pitkänen K, Sivenius J, et al.: Cutaneous electrical stimulation may enhance sensorimotor recovery in chronic stroke. Clin Rehabil, 2002, 16: 709–716.
16) Lin Z, Yan T: Long-term effectiveness of neuromuscular electrical stimulation for promoting motor recovery of the upper extremity after stroke. J Rehabil Med, 2011, 43: 506–510.
5) Kim JH, Lee LK, Lee JU, et al.: A pilot study on the effect of functional electrical stimulation of stroke patients in a sitting position on balance and activities of daily living. J Phys Ther Sci, 2013, 25: 1097–1101.
12) Schuhfried O, Crevenna R, Fialka-Moser V, et al.: Non-invasive neuromuscular electrical stimulation in patients with central nervous system lesions: an educational review. J Rehabil Med, 2012, 44: 99–105.
2) Duncan PW, Lai SM, Keighley J: Defining post-stroke recovery: implications for design and interpretation of drug trials. Neuropharmacology, 2000, 39: 835–841.
7) Levine M, McElroy K, Stakich V, et al.: Comparing conventional physical therapy rehabilitation with neuromuscular electrical stimulation after TKA. Orthopedics, 2013, 36: e319–e324.
1) Boyaci A, Topuz O, Alkan H, et al.: Comparison of the effectiveness of active and passive neuromuscular electrical stimulation of hemiplegic upper extremities: a randomized, controlled trial. Int J Rehabil Res, 2013, 36: 315–322.
17) Sahin N, Ugurlu H, Albayrak I: The efficacy of electrical stimulation in reducing the post-stroke spasticity: a randomized controlled study. Disabil Rehabil, 2012, 34: 151–156.
15) Hu XL, Tong RK, Ho NS, et al.: Wrist rehabilitation assisted by an electromyography-driven neuromuscular electrical stimulation robot after stroke. Neurorehabil Neural Repair, 2014.
14) Wolf SL, Winstein CJ, Miller JP, et al.: Retention of upper limb function in stroke survivors who have received constraint-induced movement therapy: the EXCITE randomised trial. Lancet Neurol, 2008, 7: 33–40.
3) Aoyagi Y, Tsubahara A: Therapeutic orthosis and electrical stimulation for upper extremity hemiplegia after stroke: a review of effectiveness based on evidence. Top Stroke Rehabil, 2004, 11: 9–15.
4) Malhotra S, Rosewilliam S, Hermens H, et al.: A randomized controlled trial of surface neuromuscular electrical stimulation applied early after acute stroke: effects on wrist pain, spasticity and contractures. Clin Rehabil, 2013, 27: 579–590.
10) Shimodozono M, Noma T, Matsumoto S, et al.: Repetitive facilitative exercise under continuous electrical stimulation for severe arm impairment after sub-acute stroke: a randomized controlled pilot study. Brain Inj, 2014, 28: 203–210.
6) Kim MY, Kim JH, Lee JU, et al.: The effects of functional electrical stimulation on balance of stroke patients in the standing posture. J Phys Ther Sci, 2012, 24: 77–81.
9) Hsu SS, Hu MH, Wang YH, et al.: Dose-response relation between neuromuscular electrical stimulation and upper-extremity function in patients with stroke. Stroke, 2010, 41: 821–824.
11
12
13
14
15
16
17
18
1
2
3
4
5
6
7
8
9
10
23464951 - Orthopedics. 2013 Mar;36(3):e319-24
24259923 - J Phys Ther Sci. 2013 Sep;25(9):1097-101
15788340 - J Rehabil Med. 2005 Mar;37(2):65-74
24508928 - Am J Phys Med Rehabil. 2014 Jun;93(6):503-10
20203321 - Stroke. 2010 Apr;41(4):821-4
22334346 - J Rehabil Med. 2012 Feb;44(2):99-105
10699448 - Neuropharmacology. 2000 Mar 3;39(5):835-41
25549656 - Neurorehabil Neural Repair. 2015 Sep;29(8):767-76
18077218 - Lancet Neurol. 2008 Jan;7(1):33-40
23579106 - Int J Rehabil Res. 2013 Dec;36(4):315-22
24304090 - Brain Inj. 2014;28(2):203-10
8734610 - J Neurophysiol. 1996 May;75(5):2144-9
15480949 - Top Stroke Rehabil. 2004 Summer;11(3):9-15
23129814 - Clin Rehabil. 2013 Jul;27(7):579-90
21533330 - J Rehabil Med. 2011 May;43(6):506-10
21999668 - Disabil Rehabil. 2012;34(2):151-6
12428819 - Clin Rehabil. 2002 Nov;16(7):709-16
References_xml – reference: 6) Kim MY, Kim JH, Lee JU, et al.: The effects of functional electrical stimulation on balance of stroke patients in the standing posture. J Phys Ther Sci, 2012, 24: 77–81.
– reference: 18) Noma T, Matsumoto S, Shimodozono M, et al.: Novel neuromuscular electrical stimulation system for the upper limbs in chronic stroke patients: a feasibility study. Am J Phys Med Rehabil, 2014, 93: 503–510.
– reference: 10) Shimodozono M, Noma T, Matsumoto S, et al.: Repetitive facilitative exercise under continuous electrical stimulation for severe arm impairment after sub-acute stroke: a randomized controlled pilot study. Brain Inj, 2014, 28: 203–210.
– reference: 4) Malhotra S, Rosewilliam S, Hermens H, et al.: A randomized controlled trial of surface neuromuscular electrical stimulation applied early after acute stroke: effects on wrist pain, spasticity and contractures. Clin Rehabil, 2013, 27: 579–590.
– reference: 2) Duncan PW, Lai SM, Keighley J: Defining post-stroke recovery: implications for design and interpretation of drug trials. Neuropharmacology, 2000, 39: 835–841.
– reference: 12) Schuhfried O, Crevenna R, Fialka-Moser V, et al.: Non-invasive neuromuscular electrical stimulation in patients with central nervous system lesions: an educational review. J Rehabil Med, 2012, 44: 99–105.
– reference: 1) Boyaci A, Topuz O, Alkan H, et al.: Comparison of the effectiveness of active and passive neuromuscular electrical stimulation of hemiplegic upper extremities: a randomized, controlled trial. Int J Rehabil Res, 2013, 36: 315–322.
– reference: 3) Aoyagi Y, Tsubahara A: Therapeutic orthosis and electrical stimulation for upper extremity hemiplegia after stroke: a review of effectiveness based on evidence. Top Stroke Rehabil, 2004, 11: 9–15.
– reference: 5) Kim JH, Lee LK, Lee JU, et al.: A pilot study on the effect of functional electrical stimulation of stroke patients in a sitting position on balance and activities of daily living. J Phys Ther Sci, 2013, 25: 1097–1101.
– reference: 11) Peurala SH, Pitkänen K, Sivenius J, et al.: Cutaneous electrical stimulation may enhance sensorimotor recovery in chronic stroke. Clin Rehabil, 2002, 16: 709–716.
– reference: 13) Nudo RJ, Milliken GW: Reorganization of movement representations in primary motor cortex following focal ischemic infarcts in adult squirrel monkeys. J Neurophysiol, 1996, 75: 2144–2149.
– reference: 17) Sahin N, Ugurlu H, Albayrak I: The efficacy of electrical stimulation in reducing the post-stroke spasticity: a randomized controlled study. Disabil Rehabil, 2012, 34: 151–156.
– reference: 14) Wolf SL, Winstein CJ, Miller JP, et al.: Retention of upper limb function in stroke survivors who have received constraint-induced movement therapy: the EXCITE randomised trial. Lancet Neurol, 2008, 7: 33–40.
– reference: 15) Hu XL, Tong RK, Ho NS, et al.: Wrist rehabilitation assisted by an electromyography-driven neuromuscular electrical stimulation robot after stroke. Neurorehabil Neural Repair, 2014.
– reference: 8) de Kroon JR, Ijzerman MJ, Chae J, et al.: Relation between stimulation characteristics and clinical outcome in studies using electrical stimulation to improve motor control of the upper extremity in stroke. J Rehabil Med, 2005, 37: 65–74.
– reference: 7) Levine M, McElroy K, Stakich V, et al.: Comparing conventional physical therapy rehabilitation with neuromuscular electrical stimulation after TKA. Orthopedics, 2013, 36: e319–e324.
– reference: 16) Lin Z, Yan T: Long-term effectiveness of neuromuscular electrical stimulation for promoting motor recovery of the upper extremity after stroke. J Rehabil Med, 2011, 43: 506–510.
– reference: 9) Hsu SS, Hu MH, Wang YH, et al.: Dose-response relation between neuromuscular electrical stimulation and upper-extremity function in patients with stroke. Stroke, 2010, 41: 821–824.
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  doi: 10.1177/0269215512464502
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  doi: 10.1097/PHM.0000000000000056
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  doi: 10.3109/09638288.2011.593679
– ident: 7
  doi: 10.3928/01477447-20130222-20
– ident: 11
  doi: 10.1191/0269215502cr543oa
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– ident: 16
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– ident: 8
  doi: 10.1080/16501970410024190
– ident: 13
  doi: 10.1152/jn.1996.75.5.2144
– ident: 9
  doi: 10.1161/STROKEAHA.109.574160
– ident: 12
  doi: 10.2340/16501977-0941
– reference: 23579106 - Int J Rehabil Res. 2013 Dec;36(4):315-22
– reference: 18077218 - Lancet Neurol. 2008 Jan;7(1):33-40
– reference: 24304090 - Brain Inj. 2014;28(2):203-10
– reference: 23464951 - Orthopedics. 2013 Mar;36(3):e319-24
– reference: 23129814 - Clin Rehabil. 2013 Jul;27(7):579-90
– reference: 10699448 - Neuropharmacology. 2000 Mar 3;39(5):835-41
– reference: 20203321 - Stroke. 2010 Apr;41(4):821-4
– reference: 12428819 - Clin Rehabil. 2002 Nov;16(7):709-16
– reference: 24508928 - Am J Phys Med Rehabil. 2014 Jun;93(6):503-10
– reference: 15480949 - Top Stroke Rehabil. 2004 Summer;11(3):9-15
– reference: 21533330 - J Rehabil Med. 2011 May;43(6):506-10
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Snippet [Purpose] This study investigated the effects of a 12-hour neuromuscular electrical stimulation program in the evening hours on upper extremity function in...
[Abstract.] [Purpose] This study investigated the effects of a 12-hour neuromuscular electrical stimulation program in the evening hours on upper extremity...
[Purpose] This study investigated the effects of a 12-hour neuromuscular electrical stimulation program in the evening hours on upper extremity function in...
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SubjectTerms Neuromuscular electrical stimulation
Original
Stroke
Upper extremity function
Title Effects of a 12-hour neuromuscular electrical stimulation treatment program on the recovery of upper extremity function in sub-acute stroke patients: a randomized controlled pilot trial
URI https://www.jstage.jst.go.jp/article/jpts/27/7/27_jpts-2015-190/_article/-char/en
http://mol.medicalonline.jp/en/journal/download?GoodsID=ca8jjpts/2015/002707/064&name=2327-2331e
https://www.ncbi.nlm.nih.gov/pubmed/26311975
https://www.proquest.com/docview/1708163379
https://pubmed.ncbi.nlm.nih.gov/PMC4540873
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