Article

OBJECTIVE: To investigate whether treatment with surface neuromuscular electrical
stimulation to the wrist extensors improves recovery of arm function in severely
disabled patients with stroke. DESIGN: Single blinded randomized controlled
trial. SETTING: Acute stroke unit and stroke rehabilitation wards of a university
hospital. PARTICIPANTS: Patients with no upper limb function (Action Research Arm
Test [ARAT] score 0) (N=90; mean age +/- SD, 74+/-11y; 49% men) were recruited to
the study within 6 weeks of stroke. Only 67 participants were alive at the end of
the study and data from 66 of these people were analyzed. INTERVENTIONS:
Participants were randomized to surface neuromuscular electrical stimulation
using surface electrical stimulators for 30 minutes, twice in a working day for 6
weeks in addition to standardized upper limb therapy or just standardized upper
limb therapy. MAIN OUTCOME MEASURE: The primary outcome measure was the ARAT
score. Assessments were made at baseline and at 6, 12, 24, and 36 weeks after
recruitment. RESULTS: There were statistically significant improvements in
measures of wrist extensor (mean difference 0.5; 95% confidence interval [CI],
0.0-1.0) and grip strength (mean difference 0.9; 95% CI, 0.1-1.7) over the
treatment period. Arm function (ARAT score) was not significantly different
between the groups over the treatment period at 6 weeks (mean difference 1.9; 95%
CI, -2.9 to 6.8) or over the study period at 36 weeks (mean difference 6.4; 95%
CI, -1.8 to 14.7), and the rate of recovery was not significantly different (mean
difference 0.7; 95% CI, -0.2 to 1.6). CONCLUSIONS:
In patients with severe
stroke, with no functional arm movement, electrical stimulation of wrist
extensors improves muscle strength for wrist extension and grip, and larger
studies are required to study its influence on arm function.
CI - Copyright (c) 2012 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS