From the Departments of Physical Medicine and Rehabilitation (J.C., F.B.,
T.B., L.D., T.D.) and Orthopedics (J.C., F.B.), MetroHealth Medical Center,
Cleveland, Ohio, and the Center for Physical Medicine and Rehabilitation
(J.C.) and Rehabilitation Engineering Center (J.C., F.B.), Case Western
Reserve University School of Medicine, Cleveland, Ohio.
Correspondence to John Chae, MD, Center for Physical Medicine and Rehabilitation, Case Western Reserve University, MetroHealth Medical Center, 2500 MetroHealth Dr, Cleveland, OH 44109-1998. E-mail jchae{at}metrohealth.org
Background and Purpose—The purpose
of this study was to assess the efficacy of neuromuscular stimulation
in enhancing the upper extremity motor and functional recovery of acute
stroke survivors.
Methods—Forty-six stroke survivors admitted to an inpatient
rehabilitation unit were randomly assigned to receive either
neuromuscular stimulation or placebo. Twenty-eight subjects completed
the study. The treatment group received surface neuromuscular
stimulation to produce wrist and finger extension exercises. The
control group received placebo stimulation over the paretic forearm.
All subjects were treated 1 hour per day, for a total of 15 sessions.
Outcomes were assessed in a blinded manner with the upper extremity
component of the Fugl-Meyer Motor Assessment and the self-care
component of the Functional Independence Measure at pretreatment, after
treatment, and at 4 and 12 weeks after treatment.
Results—The treatment subjects and control subjects had
comparable baseline characteristics. Parametric
analyses revealed significantly greater gains in Fugl-Meyer
scores for the treatment group after treatment (13.1 versus 6.5;
P=0.05), at 4 weeks after treatment (17.9 versus 9.7;
P=0.05), and at 12 weeks after treatment (20.6 versus
11.2; P=0.06). Functional Independence Measure scores
were not different between groups at any of the time periods
(P>0.10).
Conclusions—Data suggest that neuromuscular stimulation enhances
the upper extremity motor recovery of acute stroke survivors. However,
the sample size in this study was too small to detect any significant
effect of neuromuscular stimulation on self-care function.
© 1998 American Heart Association, Inc.
Original Contributions
Neuromuscular Stimulation for Upper Extremity Motor and Functional Recovery in Acute Hemiplegia
Key Words: hemiplegia • motor recovery • rehabilitation
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