Effect of biofeedback electrical stimulation combined with early intensive rehabilitation training on stroke rehabilitation

 What other protocols is your doctor using to significantly improve cerebral blood flow immediately post stroke? The first hours and days? NOTHING? Then you DON'T have a functioning stroke doctor, do you?

Maybe these, why isn't your incompetent doctor already delivering these to you?

cerebral blood flow (41 posts to July 2016)

oxygen delivery (31 posts to January 2020)

Effect of biofeedback electrical stimulation combined with early intensive rehabilitation training on stroke rehabilitation

Tianxiao Chen ¹, Jialiang Yang ¹, Juncheng Yan ², Xiaowei Ding ²

PMCID: PMC11826163

Abstract

Objectives: 

To investigate the efficacy of biofeedback electrical stimulation combined with early intensive rehabilitation training on cerebral blood circulation, neurological function recovery, motor performance, and self-care abilities in stroke patients. 

Methods: 

A retrospective analysis was conducted on 120 stroke patients admitted to the Affiliated Hangzhou First People’s Hospital, School of Medicine, Westlake University from September 2021 to October 2023. Patients were divided into an observation group (n=60) receiving the combined treatment and a control group (n=60) receiving standard rehabilitation. Efficacy was evaluated through the analysis of brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) levels, as well as assessments of several clinical variables, including Peak Systolic Velocity (PSV), Mean Velocity (Vm), Resistance Index (RI), Fugl-Meyer Assessment (FMA), Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Berg Balance Scale (BBS), National Institutes of Health Stroke Scale (NIHSS), Modified Barthel Index (MBI), and Stroke-Specific Quality of Life Scale (SS-QOL). Measurements were taken before treatment and upon completion. 

Results: 

The findings revealed that the combination of electrical stimulation with early rehabilitation exercises significantly improved cerebral blood flow in stroke patients. This approach accelerated the recovery of neurological functions, enhanced motor skills, and improved self-care capabilities among participants. The results demonstrated substantial treatment benefits alongside a favorable safety profile. Conclusions: The integration of biofeedback electrical stimulation with intensive rehabilitation exercises significantly enhances neurological and motor function recovery in stroke patients while promoting better self-care skills, all within a safe treatment framework. This approach warrants further clinical research and potential implementation.

You need this improved blood flow immediately, waiting until you can do exercises and biofeedback is way too late to save neurons from the neuronal cascade of death in the first week!

Keywords: Stroke, electrical stimulation, rehabilitation training

Introduction

Cerebral stroke, commonly referred to as stroke or cerebrovascular accident (CVA), is a medical emergency characterized by either the abrupt obstruction of a cerebral blood vessel, leading to the cessation of blood flow to downstream brain tissue, or the sudden rupture of a blood vessel, resulting in local hemorrhage and subsequent necrosis of brain cells and tissues [1]. Epidemiological data indicates that after the age of 50, stroke and coronary heart disease are the primary contributors to disability-adjusted life years (DALYs). Globally, stroke is the second leading cause of mortality, accounting for 11.6% of all deaths, and ranks third in terms of disability, representing 5.7% of total DALYs [2]. Without prompt medical intervention, patients may develop severe complications such as cerebral edema and herniation, which can significantly jeopardize their health and overall survival [3].

In the current landscape of medical advancements, the clinical management of hemiplegia resulting from stroke primarily relies on foundational therapeutic medications and rehabilitative exercises aimed at alleviating patient symptoms. While this conventional strategy holds promise for enhancing clinical outcomes, further investigative studies are imperative to substantiate the efficacy of this treatment regime. Notably, such treatment protocols often require extended durations and are associated with gradual symptom improvement. Functional Electrical Stimulation (FES) emerges as an innovative approach in this context. It transmits control signals to the neuromuscular system via low-frequency electrical impulses generated by external devices, facilitating the restoration of motor function in stroke patients. The overarching objective of FES-based rehabilitation therapy is to restore pre-stroke motor capabilities by promoting neural plasticity, thereby offering a dynamic and potentially more effective pathway to recovery.

FES operates by applying low-frequency electrical stimulation to neuromuscular cells, generating action potentials that propagate along nerves to skeletal muscle, inducing muscle contractions and improving motor function. Evidence suggests that FES can improve the walking ability of patients with chronic hemiplegia. By stimulating both dorsal and plantar flexors simultaneously, and when combined with intensive, repetitive walking exercises, FES can significantly enhance walking function, thereby facilitating daily activities. Notably, substantial benefits from FES have been observed even three months post-treatment [4]. Clinical trials have demonstrated the efficacy of combining rehabilitation training with low-frequency pulse electrical stimulation therapy in the treatment of stroke-induced hemiplegia. When these two approaches are integrated, a superior therapeutic effect is often achieved, suggesting a more effective treatment strategy for patients [5,6]. Based on this context, this research aims to investigate the clinical efficacy of a combined approach involving rehabilitation exercises and low-frequency pulse electrical stimulation in the treatment of stroke patients.

More at link.