Therapeutic neural effects of electrical stimulation

Abstract-This paper describes a clinical randomized singleblinded study of the effects of Functional Electrical Therapy (FET) on the paretic arms of subjects with acute hemiplegia caused by strokes. FET is an exercise program that comprises voluntary arm movements and opening, closing, holding, and releasing of objects that are assisted by a neural prosthesis (electrical stimulation). FET consisted of a 30 min everyday exercise for 3 consecutive weeks in addition to conventional therapy. Twenty-eight acute hemiplegic subjects participated in a 6 mo study. The subjects were divided into lower functioning groups (LFGs) and higher functioning groups (HFGs) based on their capacity to voluntarily extend the wrist and fingers against the gravity, and were randomly assigned to controls or FET groups. The outcomes included the Upper Extremity Function Test, the coordination of elbow and shoulder movements, spasticity of key muscles of the paretic arm, and Reduced Upper Extremity Motor Activity Log. FET and control groups showed a recovery trend in all outcome measures. The gains in FET groups were much larger compared with the gains in control groups. The speed of recovery in FET groups was substantially faster compared with the recovery rate in control groups during the first 3 weeks (treatment). The LFG subjects showed less improvement than the HFG in both the FET and control groups.

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“…Our results that show electrical stimulation helps in reduction of spasticity follow the findings from several previous studies [16,30,31].…”

Section: Discussionsupporting

confidence: 81%

Clinical evaluation of Functional Electrical Therapy in acute hemiplegic subjects

Popović

Popović²,

Sinkjær³

et al. 2003

JRRD

144

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“…3,4 External electrical stimulation has been shown to affect neural plasticity. 5 It was hypothesized that stimulation of the motor axons restore the nerve conduction by modifying the synaptic organization in the central nervous system. 6 Reciprocal movements similar to walking such as cycling may also lead to central activation via lower extremity reciprocal sensory feedback.…”

Section: Introductionmentioning

confidence: 99%

The effect of functional electrical stimulation cycling on late functional improvement in patients with chronic incomplete spinal cord injury

et al. 2015

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Study design: Prospective single-arm study. Objectives: To investigate the effect of functional electrical stimulation (FES) cycling on late functional recovery, spasticity, gait parameters and oxygen consumption during walking in patients with chronic incomplete spinal cord injury (SCI). Setting: Turkish Armed Forces Rehabilitation Center, Ankara, Turkey. Methods: Ten patients with chronic (duration of more than 2 years) incomplete SCI who could ambulate at least 10 m independently or with the assistance of a cane or walker, but no hip-knee-ankle-foot orthosis. The subjects underwent 1-h FES cycling sessions three times a week for 16 weeks. Outcome measures including the total motor score, the Functional Independence Measure (FIM) score, the Modified Ashworth Scale for knee spasticity, temporal spatial gait parameters and oxygen consumption rate during walking were assessed at baseline, 3 and 6 months after the baseline. Results: There were statistically significant improvements in total motor scores, the FIM scores and spasticity level at the 6-month follow-up (Po0.01). The changes in gait parameters reached no significant level (P40.05). Oxygen consumption rate of the patients showed significant reduction at only 6 months compared with baseline (Po0.01). Conclusion:The results suggest that FES cycling may provide some functional improvements in the late period of SCI.

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“…[4][5][6][7] A neurological mechanism for such changes has been hypothesized. 8 Now, the potential role of neuroprostheses as therapeutic interventions in clinical practice is beginning to be realized.…”

Section: Introductionmentioning

confidence: 99%

Functional electrical therapy: retraining grasping in spinal cord injury

et al. 2005

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Objective: To determine the clinical efficacy of functional electrical therapy in the rehabilitation of grasping function for quadriplegics. Study design: Randomized intervention-versus-control trial. Setting: Rehabilitation hospital for spinal cord injury in Toronto, Canada. Methods: A total of 21 people with new spinal cord injuries ranging from C3 to C7 were randomly assigned to two groups: Control (N ¼ 9) and Intervention (N ¼ 12). The intervention was functional electrical therapy, which consisted of repetitive grasping exercises using a neuroprosthesis that applied surface electrical stimulation to the arm to generate and/or assist grasping movements. It was applied by registered Occupational Therapists in a clinical setting. Main outcome measures were: Functional Independence Measure (FIM), Spinal Cord Independence Measure (SCIM), and the Rehabilitation Engineering Laboratory Hand Function Test. Consumer perceptions of functional electrical therapy were assessed via qualitative interviews. Results: Differences between the Control and Intervention groups could be observed although they are not significant due to an insufficient number of participants. Consumer perceptions were positive, including improved Activities of Daily Living and self-satisfaction. Conclusion: Functional electrical therapy has the potential to be an effective treatment modality to restore grasping function in quadriplegia. It can be implemented by occupational therapists in a clinical setting. Further research is required to establish suitable indications for participant selection. In addition, a larger number of participants is needed to demonstrate statistical significance of the Functional Electrical Therapy.

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Therapeutic neural effects of electrical stimulation

Cited by 62 publications

References 55 publications

Clinical evaluation of Functional Electrical Therapy in acute hemiplegic subjects

Clinical evaluation of Functional Electrical Therapy in acute hemiplegic subjects

The effect of functional electrical stimulation cycling on late functional improvement in patients with chronic incomplete spinal cord injury

Functional electrical therapy: retraining grasping in spinal cord injury

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