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Effects of functional electrical stimulation-cycling on shoulder pain and subluxation in patients with acute–subacute stroke

a pilot study

Karaahmet, Ozgur Z.a; Gurcay, Edab; Unal, Zeynep K.a; Cankurtaran, Damlaa; Cakci, Aytula

International Journal of Rehabilitation Research: March 2019 - Volume 42 - Issue 1 - p 36–40
doi: 10.1097/MRR.0000000000000319
Original articles

Functional electrical stimulation (FES)-cycling is a technique used to provide voluntary muscle contraction during a functional task. The aims were primarily to determine the effects of FES-cycling on shoulder pain and subluxation, and secondarily to evaluate the improvement of upper extremity motor function in patients with acute–subacute stroke patient. In this prospective trial, 21 patients with acute–subacute stroke, randomly assigned into the FES-cycling group or the standard rehabilitation program (control group). Analyses of shoulder subluxation were carried out by radiography. The numeric rating scale was used to evaluate the intensity of pain, Fugl-Meyer and Frenchay arm tests for motor function, and functional independence measure for functional status. The outcome data were evaluated at baseline and at the end of 4-week treatment. Intragroup comparisons showed improvement of acromiohumeral distance, Fugl-Meyer assessment, and functional independence measure in both groups after treatment. In intergroup comparison, FES-cycling group exerted better outcomes in shoulder pain compared with the control group (P=0.015). Correlation analyses demonstrated only positive correlation between shoulder subluxation and pain (P=0.022). FES-cycling was superior to standard rehabilitation therapy for shoulder pain relief in patients with acute–subacute stroke. Therefore, combining FES-cycling with a standard rehabilitation program alleviates shoulder pain and may prevent development of shoulder subluxation over time.

aDepartment of Physical Therapy and Rehabilitation, Dişkapi Yildirim Beyazit Education and Research Hospital

bGaziler Physical Medicine and Rehabilitation Education and Research Hospital, Ankara, Turkey

Correspondence to Eda Gurcay, MD, Gaziler Physical Medicine and Rehabilitation Education and Research Hospital, 06800 Ankara, Turkey Tel: +90 312 291 1403; fax: +90 312 291 1009; e-mail:

Received August 3, 2018

Accepted September 3, 2018

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