The efficacy of electrical stimulation in reducing the post-stroke spasticity: a randomized controlled study

Area of Science:

• Neurorehabilitation
• Physical Therapy
• Neurology

Background:

• Stroke survivors often experience upper limb spasticity, impacting motor function and daily living.
• Wrist flexor spasticity is a common challenge following a cerebrovascular event.
• Effective management strategies are crucial for improving quality of life in stroke patients.

Purpose of the Study:

• To assess the effectiveness of surface electrical stimulation on wrist flexor spasticity after stroke.
• To compare the efficacy of combined neuromuscular electrical stimulation (NMES) and stretching versus stretching alone.
• To evaluate the impact on spasticity, range of motion, and functional recovery.

Main Methods:

• Hemiplegic patients with wrist spasticity (Ashworth scale stage 2-3) were divided into two groups.
• Both groups received stretching; one group additionally received NMES to wrist extensors (100 Hz, 0.1 ms pulse duration, 9s rest, 15 min).
• Outcomes measured included Modified Ashworth Scale (MAS), Fmax/Mmax and Hmax/Mmax ratios, wrist ROM, Functional Independence Measurement (FIM), and Brunnstrom motor staging.

Main Results:

• Both treatment groups showed significant improvements in MAS, electrophysiological measures, wrist ROM, FIM, and Brunnstrom staging.
• The group receiving combined NMES and stretching demonstrated superior improvements in MAS, wrist ROM, FIM, and Brunnstrom staging compared to stretching alone.
• NMES combined with stretching yielded better outcomes in reducing spasticity and enhancing motor recovery.

Conclusions:

• Neuromuscular electrical stimulation (NMES) combined with stretching is more effective than stretching alone for reducing post-stroke wrist spasticity.
• This combined approach significantly enhances wrist range of motion and functional independence.
• NMES offers a valuable adjunct therapy for neurorehabilitation after cerebrovascular events.