Modern Upper-Limb Rehabilitation Interventions in Stroke Patients with Spasticity

Background: Upper-limb rehabilitation is a decisive factor in improving the quality of life for patients who have experienced a stroke. Modern rehabilitation techniques promote the recovery of upper-limb functionality and prehension, contributing to a reduction in disability. Materials and Methods: This retrospective observational study aimed to highlight improvements in prehension through the application of current actual and modern rehabilitation techniques targeting key muscle groups involved in upper-limb recovery. Data from a total of 52 patients were identified and categorized into two groups based on the specific rehabilitation protocols they received during their hospitalization: a study group and a control group. Both groups underwent individualized rehabilitation, differing only in the type of electrotherapy applied: the study group received functional electrical stimulation (FES) and shock wave therapy (RSWT), while the control group received conventional electrical stimulation. Results: After adjusting for baseline differences in severity and time since stroke, patients in the study group demonstrated a significantly greater improvement in functional parameters compared to the control group. The results show us a significant improvement of functionality after RSWT and FES in the study group, with values from 0.28 ± 0.28 to 0.99 ± 0.36 (p-value < 0.001) regarding Hand Grip, suggesting that the treatment effect persists even when initial clinical advantages in the control group are accounted for. Muscle force increased from 0.39 ± 0.54 to 7.67 ± 3.89, p-value < 0.001. Conclusions: The combined application of functional electrical stimulation and shock wave therapy, as modern rehabilitation interventions, provided additional benefits in upper-limb and prehension rehabilitation compared to classical electrical stimulation alone. Our findings suggest that the combined application of RSWT and FES is strongly associated with improved upper-limb recovery, even after adjusting for baseline clinical imbalances. While these results support the integration of these modern techniques into stroke protocols, further prospective randomized controlled trials are needed to confirm the definitive treatment advantage over conventional methods.