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Neuromuscular electrical stimulation improves severe hand dysfunction for individuals with chronic stroke: a pilot
Marcio Santos1, Laura H Zahner, Brian J McKiernan
1Landon Center on Aging, Kansas University Medical Center, USA.
Journal of Neurologic Physical Therapy : JNPT
|January 20, 2007
Summary
Neuromuscular electrical stimulation (NMES) improved hand function in chronic stroke survivors. NMES-assisted grasping showed greater functional benefits than passive wrist stimulation for reducing severe hand impairments.
Area of Science:
- Neuroscience
- Rehabilitation Medicine
- Biomedical Engineering
Background:
- Restoring hand function after stroke remains a significant clinical challenge.
- Severe hand impairments frequently persist in individuals with chronic stroke.
- Neuromuscular electrical stimulation (NMES) is a potential therapeutic modality for motor recovery.
Purpose of the Study:
- To evaluate the efficacy of two NMES protocols in reducing severe hand impairments in chronic stroke survivors.
- To compare the functional benefits of active NMES-assisted grasping versus passive NMES wrist stimulation.
- To assess the impact of NMES on upper extremity motor performance and spasticity.
Main Methods:
- Eight chronic stroke subjects received 10 sessions of NMES using two counterbalanced methods: active NMES-assisted grasping and passive NMES wrist stimulation.
- Interventions involved novel multi-stimulator application for active grasping and repeated wrist flexion/extension for passive stimulation.
- Motor performance, including grasping speed and dexterity, and spasticity (Modified Ashworth Spasticity Scale) were assessed pre- and post-intervention and at retention.
Main Results:
- Both NMES interventions significantly improved Upper Extremity Fugl-Myer scores immediately post-treatment (p < 0.002).
- Significant reduction in spasticity (MASS) was observed post-intervention (p < 0.03), primarily with passive NMES (p < 0.034).
- Grasping task performance speed significantly increased (p < 0.0433) post-intervention, with NMES-assisted grasping showing a ~10% improvement in dexterous manipulation compared to ~0.1% for passive NMES.
Conclusions:
- Short-duration NMES therapy can reduce severe hand impairment in individuals with chronic stroke.
- NMES-assisted grasping demonstrated a trend towards greater functional benefits compared to traditional passive wrist NMES.
- Further research is warranted to optimize NMES protocols for enhanced hand function recovery post-stroke.
