Functional electrical stimulation on chronic and acute hemiplegic shoulder subluxation

Area of Science:

• Rehabilitation Medicine
• Neuroscience
• Biomechanics

Background:

• Shoulder subluxation is a common complication in hemiplegic patients.
• Effective management strategies are crucial for improving patient outcomes and function.

Purpose of the Study:

• To evaluate the efficacy of functional electrical stimulation (FES) for managing acute and chronic shoulder subluxation in hemiplegic individuals.
• To compare the effectiveness of FES based on the duration of postonset symptoms.

Main Methods:

• A randomized controlled trial design was employed, categorizing participants into short-duration (acute) and long-duration (chronic) groups.
• Participants were further assigned to experimental (FES) or control subgroups.
• The experimental groups received FES targeting the supraspinatus and posterior deltoid muscles for up to 6 hours daily over 6 weeks, with progressive increases in duration and intensity.

Main Results:

• The short-duration experimental group demonstrated significant reduction in shoulder subluxation, confirmed by X-ray, after the initial FES treatment compared to controls.
• No significant improvement in subluxation was observed in the long-duration experimental group after the first FES treatment.
• A second FES treatment program yielded insignificant changes in shoulder subluxation for both short- and long-duration groups.

Conclusions:

• Functional electrical stimulation (FES) is an effective intervention for reducing shoulder subluxation in hemiplegic patients with recent onset (<1 year).
• FES demonstrated limited efficacy for managing chronic shoulder subluxation in patients with symptoms exceeding one year postonset.