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Novel Neuromuscular Electrical Stimulation System for the Upper Limbs in Chronic Stroke Patients: A Feasibility Study

Noma, Tomokazu OT, MHSc; Matsumoto, Shuji MD, PhD; Shimodozono, Megumi MD, PhD; Iwase, Yoshiaki OT, MA; Kawahira, Kazumi MD, PhD

American Journal of Physical Medicine & Rehabilitation: June 2014 - Volume 93 - Issue 6 - p 503–510
doi: 10.1097/PHM.0000000000000056
Original Research Articles

Objective The aim of this study was to assess the feasibility of applying a novel neuromuscular electrical stimulation system, targeting shoulder flexion, elbow extension, wrist extension, and individual finger extensions, to improve motor control and function of the hemiparetic upper limbs in chronic stroke patients.

Design Fifteen participants with chronic (>1 yr after cerebrovascular accident) upper limb hemiparesis were enrolled. The subjects underwent upper limb training for 60 mins per day, 6 days per week, for 2 wks, using both a shoulder-and-elbow stimulation device and a wrist-and-finger stimulation device developed by the study investigators. Outcomes were assessed using the upper extremity component of the Fugl-Meyer assessment, the action research arm test, and the modified Ashworth scale before and after intervention.

Results All patients completed the training successfully using the neuromuscular electrical stimulation system without any safety incidents or other complications reported. Nonparametric statistical analyses indicated significant improvements in the upper extremity component of the Fugl-Meyer assessment and action research arm test scores, both at P < 0.01. There were also significant reductions in modified Ashworth scale scores for the elbow and the wrist flexor, both at P < 0.01.

Conclusions The multimuscle stimulation approach and method presented in this study seem feasible, and the improvements of upper limb motor control and functional test in chronic stroke patients justify further controlled investigation.

From the Department of Rehabilitation, Kirishima Rehabilitation Center of Kagoshima University Hospital, Kagoshima, Japan (TN); and Department of Rehabilitation and Physical Medicine, Graduate School of Medical and Dental Sciences (SM, MS, KK), and Department of Basic Occupational Therapy, School of Health Sciences, Faculty of Medicine (YI), Kagoshima University, Kagoshima, Japan.

All correspondence and requests for reprints should be addressed to: Shuji Matsumoto, MD, PhD, Kirishima Rehabilitation Center of Kagoshima University Hospital, 3930-7 Takachiho, Makizono-cho, Kirishima City, Kagoshima 899-6603, Japan.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

© 2014 by Lippincott Williams & Wilkins