Effectiveness of neuromuscular electrical stimulation for wrist rehabilitation after acute ischemic stroke

Useless because it doesn't point to the protocol used or its efficacy and the starting point needed to use the protocol. 

Effectiveness of neuromuscular electrical stimulation for wrist rehabilitation after acute ischemic stroke

Guo, Xiao-xian, MB^a,*; Fan, Bai-ya, MB^a,*; Mao, Yan-yang, MD^b

Section Editor(s): Zhang., Qinhong

Medicine: September 2018 - Volume 97 - Issue 38 - p e12299

doi: 10.1097/MD.0000000000012299

Research Article: Observational Study

• Abstract
• Author Information
• Article Outline

This study investigated the effectiveness of neuromuscular electrical stimulation (NMES) for patients with wrist dysfunction after acute ischemic stroke (AIS).
A total of 82 patient cases with wrist dysfunction after AIS were selected in this study. Of these, 41 cases in the intervention group received physical training and NMES treatment. The other 41 cases in the control group received physical training only. The primary outcome was measured by Action Research Arm Test (ARAT) score. The secondary outcomes were measured by the Barthel Index (BI), and numerical rating scale (NRS).
After 4-week treatment, patients in the intervention group neither improved arm function recovery, measured by ARAT score (P = .79), and activities of daily living, measured by BI scale (P = .62), nor reduced pain, measured by the NRS scale (P = .11), compared with patients in the control group.
The results of this study demonstrated that NMES might not benefit for patients with wrist dysfunction after AIS after 4-week treatment.

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1 Introduction

Stroke is one of the most server conditions, which often results in high disability, mortality, and morbidity.^[1–3] It is reported that it has affected 7 million adults in America with 3.0% of the population from 2007 to 2010, according to the American Stroke Association statistics.^[4,5] Of those populations, many stroke survivors often suffer from limb paralysis, abnormal gait, aphasia, and other complications.^[6–8]On the other hand, the large amount of burden brings for both those survivors and the society.^[9]

Patients after stroke often require long-term rehabilitation therapy, especially for the hemiplegia in order to the restore and improve motor functions for the paralyzed limbs.^[10,11] It has been reported that more than 50% patients can not recover arm function, although most stroke survivors can regain ability to walk independently after rehabilitation.^[12] If arm function can not be recovered timely, this condition can also lead to secondary complications such as spasticity, contractures, and pain.^[12,13]

To improve the upper extremity motor function after stroke, interventions should focus on not only enhancing the arm dysfunction, but also addressing the conditions of spasticity, contractures, and pain. It has been reported that alternative therapies, including neuromuscular electrical stimulation (NMES), acupuncture, and mirror therapy intervention have the potential to facilitate recovery of arm function and also help to prevent the development to the secondary complications.^[14–18] Among these interventions, NMES is one of the most widely used therapies.^[19–22] In spite of the promising results were reported from the previous studies, insufficient evidence is still available to support that NMES is an efficacious adjunctive therapy for patients with wrist rehabilitation after chronic stroke.^[19–22]

In the present study, we investigated the effectiveness of NMES in patients with wrist rehabilitation after acute ischemic stroke (AIS) among Chinese population.