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Published on: October 11, 2024
The effects of electromyography-controlled functional electrical stimulation on upper extremity function and cortical
Yukihiro Hara1, Shigeru Obayashi, Kazuhito Tsujiuchi
1The Department of Rehabilitation Medicine, Nippon Medical School, Chiba Hokusoh Hospital, Japan. hara-y@nms.ac.jp
Objective:
The relation was investigated between hemiparetic arm function improvement and brain cortical perfusion (BCP) change during voluntary muscle contraction (VOL), EMG-controlled FES (EMG-FES) and simple electrical muscle stimulation (ES) before and after EMG-FES therapy in chronic stroke patients.
Methods:
Sixteen chronic stroke patients with moderate residual hemiparesis underwent 5 months of task-orientated EMG-FES therapy of the paretic arm once or twice a week. Before and after treatment, arm function was clinically evaluated and BCP during VOL, ES and EMG-FES were assessed using multi-channel near-infrared spectroscopy.
Results:
BCP in the ipsilesional sensory-motor cortex (SMC) was greater during EMG-FES than during VOL or ES; therefore, EMG-FES caused a shift in the dominant BCP from the contralesional to ipsilesional SMC. After EMG-FES therapy, arm function improved in most patients, with some individual variability, and there was significant improvement in Fugl-Meyer (FM) score and maximal grip strength (GS). Clinical improvement was accompanied by an increase in ipsilesional SMC activation during VOL and EMG-FES condition.
Conclusion:
The EMG-FES may have more influence on ipsilesional BCP than VOL or ES alone.
Significance:
The sensory motor integration during EMG-FES therapy might facilitate BCP of the ipsilesional SMC and result in functional improvement of hemiparetic upper extremity.
