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Severity-Dependent Peripheral Circulatory Responses to Neuroprosthetic Functional Electrical Stimulation in Chronic

Masaya Tanabe1, Akira Kimura2

  • 1Physical Therapy, Gunma Paz University, Takasaki, JPN.

Cureus
|November 14, 2025
PubMed
Summary

Neuroprosthetic functional electrical stimulation (NP-FES) shows feasibility for improving peripheral circulation in chronic stroke patients. Severe hemiplegia showed results in four weeks, while mild hemiplegia responded in two weeks.

Keywords:
blood flow estimationchronic strokefunctional electrical stimulationperipheral circulationstroke

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Area of Science:

  • Neurology
  • Rehabilitation Medicine
  • Biomedical Engineering

Background:

  • Chronic stroke often leads to paretic limb disuse, poor circulation, and cold sensations.
  • Functional electrical stimulation (FES) is studied for motor recovery, but its impact on circulation is less understood.
  • Neuroprosthetic FES (NP-FES), synchronized with electromyography (EMG), may offer enhanced vascular benefits.

Purpose of the Study:

  • To assess the feasibility of NP-FES in improving peripheral circulation in a day rehabilitation setting.
  • To determine if NP-FES induces observable circulatory changes in chronic stroke patients.
  • To investigate differences in response timelines between severe and mild hemiplegia.

Main Methods:

  • A randomized crossover trial involving 16 chronic stroke patients (8 severe, 8 mild).
  • Participants received four weeks of NP-FES and four weeks of sensory stimulation, with a two-week washout period.
  • Peripheral blood flow was estimated using venous vessel width, skin temperature, and hemoglobin levels.

Main Results:

  • NP-FES significantly increased blood flow in severe hemiplegia at week 4.
  • Sensory stimulation led to improvements in mild hemiplegia by week 2.
  • Subjective improvements were reported by 50% of severe and 75% of mild cases.

Conclusions:

  • Peripheral circulatory responses to NP-FES are detectable in clinical settings.
  • Circulation outcomes may require different timelines based on stroke severity (4 weeks for severe, 2 weeks for mild).
  • Findings support NP-FES feasibility and guide future randomized controlled trials for efficacy.