Post-Stroke Treatment with Neuromuscular Functional Electrostimulation of Antagonistic Muscles and Kinesiotherapy Evaluated with Electromyography and Clinical Studies in a Two-Month Follow-Up

Abstract

The aim of this study was to determine the sustained influence of personalized neuromuscular functional electrical stimulation (NMFES) combined with kinesiotherapy (mainly, proprioceptive neuromuscular facilitation (PNF)) on the activity of muscle motor units acting antagonistically at the wrist and the ankle in a large population of post-stroke patients. Clinical evaluations of spasticity (Ashworth scale), manual muscle testing (Lovett scale), and surface electromyography recordings at rest (rEMG) and during attempts of maximal muscle contraction (mcEMG) were performed three times in 120 post-stroke patients (T0: up to 7 days after the incidence; T1: after 21 days of treatment; T2: after 60 days of treatment). Patients (N = 120) were divided into two subgroups—60 patients received personalized NMFES and PNF treatment (NMFES+K), and the other 60 received only PNF (K). The NMFES+K therapy resulted in a decrease in spasticity and an increase in muscle strength of mainly flexor muscles, in comparison with the K group. A positive correlation between the increase of rEMG amplitudes and high Ashworth scale scores and a positive correlation between low amplitudes of mcEMG and low Lovett scale scores were found in the wrist flexors and calf muscles on the paretic side. Negative correlations were found between the rEMG and mcEMG amplitudes in the recordings. The five-grade alternate activity score of the antagonists’ actions improved in the NMFES+K group. These improvements in the results of controlled NMFES treatment combined with PNF in patients having experienced an ischemic stroke, in comparison to the use of kinesiotherapy alone, might justify the application of conjoined rehabilitation procedures based on neurophysiological approaches. Considering the results of clinical and neurophysiological studies, we suppose that NMFES of the antagonistic muscle groups acting at the wrist and the ankle may evoke its positive effects in post-stroke patients by the modulation of the activity more in the spinal motor centers, including the level of Ia inhibitory neurons, than only at the muscular level.

Dual-mobility cup total hip arthroplasty improves the quality of life compared to internal fixation in femoral neck fractures patients with severe neuromuscular disease in the lower extremity after stroke: a retrospective study

“…Herein, we retrospectively analyzed the clinical data of femoral neck fracture patients with severe stroke hemiplegia admitted to the Guangdong Hospital of Traditional Chinese Medicine in Guangzhou, China, between January 2015 and December 2020, with a minimum 1-year follow-up. The inclusion criteria were: femoral neck fracture and stroke hemiplegia, unilateral lower extremity muscular strength < grade 3/5 (Lovett scale) ( 15 ), and treatment at our institution. The exclusion criteria included bilateral lower extremity impairment, revision arthroplasty, pathological fractures, less than one year of follow-up, and lack of specific information.…”

Atrial standstill associated with lamin A/C mutation: A case report

“…Physical examination showed that the myodynamia of the distal muscle strength of the right lower limb was level 3, and the distal muscle strength of the right lower limb was level 1 by Lovett's scale. 8,9 The patient had a previous history of old cerebral infarction for 6 years, old myocardial infarction for 4 years, but did not have hypertension nor diabetes mellitus.…”

Kinesiological models of the neuromuscular system readaptation in mature women after prolonged hypokinesia

“…An urgent issue of modern kinesiology is the search for effective ways of using the results of scientific research in biomechanics and physiology to counter the processes of disadaptation. The problem of studying the mechanisms of restoring the capabilities of body systems after a long period of disadaptation caused by various factors is a priority task for a number of scientists [7][8][9]. The main issue for determining the periodization and spectrum of methods to use for the neuromuscular system readaptation is to conduct a detailed analysis of the functional and physical state of a person after a period of disadaptation.…”

“…In the available literature, there are various directions of using exercises in kinesiotherapy to solve problems with the musculoskeletal system [3,4,7,11]. However, practicing only various exercises with standard load parameters may not always correspond to the body resistance level and contribute to readaptation processes.…”