The effectiveness of early neuromuscular electrical stimulation on lower extremity functions of stroke patient

Although functional electrical stimulation (FES) and transcutaneous electrical nerve stimulation (TENS) has been used for decades, it has been only increasingly applied (in the case of FES) or has just begun to be used (in the case of TENS) in promoting recovery of hemiplegia in stroke rehabilitation over the last decade.; This study was a randomized controlled trial. The hypotheses were that, first, subjects with acute stroke, receiving early FES or TENS plus a standard rehabilitation (SR) program, would have better sensorimotor recovery than those receiving SR alone. Second, the effects of FES were earlier and stronger than that of TENS in improving sensorimotor recovery of stroke subjects.; Outcome measurements included (i) proprioception threshold of the knee joint; (ii) spasticity in the affected ankle plantarflexors; (iii) maximum isometric voluntary contraction of the ankle muscles; and (iv) functional mobility in terms of the timed “Up & Go” test. These were measured before treatment (week₀), once a week during the 3-week treatment in the hospital, and at week₈ post-stroke onset (week _FU).; The results showed no significant differences among the groups before treatment. When compared with the other 3 groups, the FES group showed a significant decrease in the affected knee proprioception threshold from week₁ to week_FU (P < 0.015).; There are 3 main conclusions from the present study. (i) Repeated FES treatment promoted earlier and better sensorimotor recovery of the affected lower extremity and functional mobility in subjects with a first stroke when FES was applied within 2 weeks from stroke onset as opposed to placebo stimulation or SR alone. (ii) Repeated TENS treatment, begun within 2 weeks from stroke onset, significantly slowed the development of spasticity of the affected ankle plantarflexors and improved motor recovery in terms of the increased torque generated by the affected dorsiflexors and decreased antagonist co-contraction when compared with subjects in the placebo and control groups. (iii) The effects of early FES intervention in improving sensorimotor recovery of stroke subjects were earlier and stronger than that of TENS. (Abstract shortened by UMI.)...