Electrical stimulation of wrist and fingers for hemiplegic patients

Passive cyclical electrical stimulation was applied during a four-week treatment program to the wrist and finger extensors of 16 hemiplegic patients with flexor spasticity. The study noted the effects of this treatment on the patients' sensation; spasticity; passive range of motion of the wrist, metacarpophalangeal, and proximal interphalangeal joints; and strength in the wrist extensor muscles. Patients were divided into chronic and subacute groups. Both groups received electrical stimulation for three half-hour periods a day, seven days a week, as a substitute for all other range-of-motion techniques. Flexion contractures were prevented in the subacute group of patients at the wrist, metacarpophalangeal, and proximal interphalangeal joints. A statistically and clinically significant increase in wrist extension range occurred in the chronic group that had wrist flexion contractures before the electrical stimulation. Increased extension was noted at the metacarpophalangeal and proximal interphalangeal joints of patients in the chronic group. Those patients with some voluntary wrist extension before the treatment began were able to increase their extension strength during stimulation. No changes in skin sensation were noted and only a general trend in decreasing spasticity was apparent.