Effect of repetitive wrist extension with electromyography-triggered stimulation after stroke: a preliminary randomized controlled study

Abstract

Objective: The purpose of this study was to explore the effect of repetitive wrist extension task training with electromyography (EMG)-triggered neuromuscular electrical stimulation (NMES) for wrist extensor muscle recovery in patients with stroke. Design: Randomized controlled trial. Methods: Fifteen subjects who had suffered a stroke were randomly assigned to an EMG-triggered NMES group (n=8) or control group (n=7); subjects in both groups received conventional therapy as usual. Subjects in the experimental group received application of EMG-triggered NMES to the wrist extensor muscles for 20 minutes, twice per day, five days per week, for a period of four weeks, and were given a task to make a touch alarm go off by activity involving extension of their wrist. In the control group, subjects performed wrist self-exercises for the same duration and frequency as those in the experimental group. Outcome measures included muscle reaction time and spectrum analysis. Assessments were performed during the pre-and post-treatment periods. Results: In the EMG-triggered NMES group, faster muscle reaction time was observed, and median frequency also showed improvement, from 68.2 to 75.3 Hz, after training (p<0.05). Muscle reaction time was significantly faster, and median frequency was significantly higher in the experimental group than in the experimental group after training. Conclusions: EMG-triggered NMES is beneficial for patients with hemiparetic stroke in recovery of upper extremity function.

Electromyogram-Related Neuromuscular Electrical Stimulation for Restoring Wrist and Hand Movement in Poststroke Hemiplegia: A Systematic Review and Meta-Analysis

“…Four studies [16][17][18]30 were excluded because of missing information (mean and/or SD) needed for data pooling. The following outcome measures were identified from the studies and pooled: (1) FMA-UE, 24,25,29,31,33,[35][36][37][38]40,41 (2) reaction time, 19,20,28,39 (3) force, 26,32,39 and (4) range of movement (ROM). 22,26 Since 6 studies compared more than 2 groups, additional grouping was done.…”

“…Studies were published between 1998 16 and 2017. [38][39][40][41] Figure 1 shows the selection of studies included in the systematic review and the main reasons for exclusion.…”

“…Sample sizes ranged from 9 16 to 122 37 participants. A majority of studies (n = 19) were conducted with chronic patients (536 patients), [17][18][19][20][21][22][23][25][26][27][28][30][31][32][33]35,[37][38][39] while 7 involved acute/subacute patients (246 patients). 16,24,29,34,36,40,41 Mean age ranged from 42.6 32 to 71.1 23 years, and stroke duration ranged from 9 days 36 to 4.8 years.…”

“…According to initial FMA-UE scores, UL impairment levels ranged in severity from moderate (n = 6) 24,25,31,35,37,38 to severe (n = 8). 16,29,30,33,36,39,40,41 Twelve studies [17][18][19][20][21][22][23][26][27][28]32,34 provided no FMA-UE score and therefore were not classified.…”

Usability Assessment of Neurostim System: A sEMG Activated Neuroprosthesis Remotely Monitorable and Configurable

“…This phenomenon could not be noticed in patients who use only NMES, although they also improved in functional tests. In [9], [12], and [13], there are pieces of evidence for the positive effects of NMES initiated by sEMG in various configurations. However, [14] presented a systematic review and meta-analysis of this modality's benefits and concluded that these are larger and evident in chronic cases.…”