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Upper limb recovery in early acute phase stroke survivors by coupled EMG-triggered and cyclic neuromuscular electrical stimulation.

BACKGROUND
Few patients with severe upper extremity (UE) paresis after stroke achieved full recovery, because of the lack of a definitive approach to improve severe UE paresis immediately after onset.


OBJECTIVE
to investigate the effects of coupled EMG-triggered and cyclic neuromuscular electrical stimulation (NMES) on UE paresis during early acute phase of stroke.


METHODS
Seventeen participants with severe UE disability met the criteria. 8 subjects received 20 minutes of NMES prior to standard care per session, while 9 age- and severity-matched subjects received two times 20 minutes of standard care. Outcome measures included UE motor section of the Fugl-Meyer Motor Assessment Scale (FMA-UE), Wolf motor function test (WMFT), and box and block test (BBT).


RESULTS
The NMES group received treatment (average session: 10.87) after a median 7 days from stroke (16.5 sessions after 5 days for control). To adjust the different treatment durations, we defined "progress rate" as the gains of UE function scores divided by treatment duration. The progress rate was significantly different in FMA-UE, but not in WMFT and BBT.


CONCLUSIONS
The present study suggested beneficial effects of coupled NMES on UE paresis during early acute phase of stroke.