Clinical Evaluation of Functional Electrical Stimulation Effectiveness of Antagonistic Muscle Groups at Wrist and Ankle in Patients After Ischemic Stroke in Long Term Follow Up

Abstract

Introduction So far, no detailed evaluation of the results of neuromuscular therapy with functional electrical stimulation combined with kinesiotherapy in long-term observation with clinical methods assessing the scale of post-stroke deficits, muscle strength and the severity of the spasticity symptom on the more paresis side has been performed. Aim The aim of this study was to compare results of neuromuscular functional electrical stimulation algorithm (NMFES) associated with a uniform system of kinesiotherapy based mainly on proprioceptive neuromuscular facilitation (PNF) procedures versus the same system of applied kinesiotherapy alone in home-based treatment of ischemic stroke patients in two months follow up. Material and methods The same set of clinical studies has been applied to a group of 25 healthy volunteers once as well as three times (T0- at hospital ward up to 7 days after an incident, T1- after 21 days of treatment at a hospital ward, T2-after 62 days of home-based treatment) to the 50 patients after ischemic stroke divided into two groups, 25 subjects each (NMFES+K and K groups). Evaluation of treatment effects in two groups of patients was performed with NIHSS scale, Lovett’s scale and Ashworth’s scale. Results After 60 days of applied treatment, only patients of the NMFES+K group represented a statistically significant decrease of NIHSS scale score, indicating the retirement of stroke symptoms. The symptom of increased muscle tension evaluated in the Ashwort’s scale in patients of the NMFES+K group significantly decreased but not in patients of K group. The muscle force of extensor muscles of upper and lower extremities significantly increased only in patients of the NMFES+K group. In general, patients from both groups did not present significant abnormalities in sensory perception within dermatomes C5-C7 and L5-S1 on the more paretic side. Conclusions The proposed personalized, safe and controlled in use a NMFES electrostimulation algorithm gives better, and long-lasting functional effects than previously used as a standard, making it a targeted treatment method. In patients after an ischemic stroke, this treatment reduces post-stroke deficits, increases muscle strength, and reduces the severity of the spasticity symptom on the more paralyzed side. Keywords: ischemic stroke, rehabilitation, functional neuromuscular stimulation, proprioceptive neuromuscular facilitation, clinical evaluation