Related Experiment Video
Updated: Aug 15, 2026
Using Home-based, Remotely Supervised, Transcranial Direct Current Stimulation for Phantom Limb Pain
Published on: March 1, 2024
Home-based electromyography-triggered stimulation in chronic stroke
Usama Gabr1, Peter Levine, Stephen J Page
1Department of Physical Medicine and Rehabilitation, University of Cincinnati College of Medicine, 3202 Eden Ave, Suite 275, Cincinnati, OH 45267, USA.
Objectives:
(1) To determine the feasibility of a home-based electromyography-triggered neuromuscular stimulation (ETMS) programme; and (2) to determine ETMS efficacy in increasing affected wrist extension and reducing affected arm impairment.
Design:
Randomized, controlled, pre-post, cross-over design.
Setting:
Outpatient rehabilitation hospital.
Patients:
Twelve chronic stroke patients with palpable muscle contraction in their affected wrist extensors but no movement (7 males; mean age = 59.75 years, age range 44-75 years; mean time since stroke = 52.75 months, range 13-131 months).
Intervention:
Subjects were randomly assigned to receive either: (a) ETMS use twice every weekday in 35-min increments during an eight-week period followed by an eight-week home exercise programme (ETMS/home exercise programme) (n=8); or (b) an eight-week home exercise programme followed by use of ETMS twice every weekday in 35-min increments during an eight-week period (home exercise programme) (n=4).
Main Outcome Measures:
The Fugl-Meyer, Action Research Arm Test and goniometry.
Results:
After home exercise programme participation, subjects showed nominal or no changes on any of the outcome measures. After ETMS, patients showed modest impairment reductions, as shown by the Fugl-Meyer, and no Action Research Arm Test changes. However, both groups showed a 21 degree increase in active affected wrist extension after ETMS use.
Conclusion:
ETMS use is feasible in the home environment. Neither participation in a traditional home exercise programme nor ETMS use conveyed changes on the Fugl-Meyer or Action Research Arm Test. However, ETMS use increased active affected limb extension. This new movement may provide a potential pathway for subjects to participate in other interventions, such as modified constraint induced therapy.
