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Updated: Jul 26, 2025
The Combined Use of Transcranial Direct Current Stimulation and Robotic Therapy for the Upper Limb
Published on: September 23, 2018
Combined effect of Brunnstrom's hand rehabilitation and functional electrical stimulation for improving hand function
Rahemun Akter1, Nidhi Sharma2, Sohel Ahmed3
1Department of Physiotherapy and Rehabilitation, Mount Adora Hospital, Akhalia, Sylhet, 3100, Bangladesh.
Background:
Motor recovery of the upper extremity is one of the most common challenging outcomes after stroke.
Objective:
To find out the combined effects of Brunnstrom hand rehabilitation (BHR) and functional electrical stimulation for improving hand functions in patients with chronic stroke.
Study Design:
Randomized controlled trial.
Method:
25 participants, both male (n = 11) and female (n = 14), age group between 40 and 70 years were randomly divided into control group (n = 12) and experimental group (n = 13). The treatment protocol was continued 5 days per week, for 4 weeks. The experimental group received Brunnstrom hand training and functional electrical stimulation (FES) along with conventional physiotherapy. The control group received only conventional physiotherapy. Participants were evaluated at baseline and after 4 weeks of intervention.
Outcome Measures:
Fugl Meyer Assessment scale-upper extremity, Modified Ashworth scale, Handheld Dynamometer, and Jabsen Taylor Hand Function Test. Paired t-test was used to compare within-group variables and an independent t-test was used for between-group comparisons. P-value was set as 0.05 to minimize type-1 error.
Results:
Statistically significant difference was obtained in favor of the experimental group undergoing FMA (p < .001), MAS (p = .004), JTHF (p = .018), and HHD (p < .001) in between-group analysis. However, both groups showed significant improvement [experimental group; FMA-UE (p < .001), MAS (p < .001); JTHF (p < .001), and HHD (p < .001), and control group; FMA-UE (p < .001), MAS (p < .001), JTHF (p < .001) and HHD (p < .001)] in within-group analysis at post-intervention.
Conclusion:
Brunnstrom hand rehabilitation and FES in combination were found to be more effective in improving hand function than conventional physiotherapy treatment.
Clinical Trial Registration:
URL: http://www.ctri.nic.in. No: CTRI/2019/06/019,905.
