Effectiveness of functional electrical stimulation on functional recovery of the affected upper extremities in subjects with stroke:a randomized controlled trial

Objective:To assess the long-dated efficacy of functional electrical stimulation (FES) in enhancing functional recovery of the affected upper extremities in subjects with stroke.Method:In a randomized controlled trial,37 subjects with first stroke were randomly assigned into 2 groups:FES group or control group.The FES group (n=19) received FES on the affected supraspinatus muscle,deltoid muscle and extensor of wrist (stimulation between 1/3 and 1/2 of distal end of dorso-forearm) through surface electrodes.The intensity of stimulation current was set to produce full shoulder abduction and wrist extension with a duty cycle of 5s on and 5s off.The stimulus pulse was a symmetric biphasic waveform with amplitude ranging between 0 to 90 mA,frequency 30 Hz,pulse width of 300μs,and ramp up and down time of 2s each.The current amplitude were adjusted to subject comfort.It lasted for 30min per d,5d per week for 3 weeks.In addition two groups received standard rehabilitation program.Measurements included Fugl-Meyer motor assessment (FMA) for upper extremity,manual muscle testing (MMT) for the shoulder myodynamia,as well as modified Barthel index(MBI) for activities of daily living.Measurements were recorded before treatment,at the 1 st,3 rd,6 th month post-treatment.Result:Before treatment,there was no significant difference between the two groups for age,stroke severity,and the baseline of measurements.Significant differences were found in the scores of FMA,MMT,MBI between two groups at the 1 st,3 rd month post-treatment(P0.05);at the 6 th month post-treatment,the scores of MBI,FMA in FES group were also higher than that in control group with significant difference (P0.05),the scores of MMT presented margined significant difference (P=0.052).Conclusion:Three weeks of FES to the affected upper extremities of subjects with early stroke improved their motor function and the efficacy could last for 6 months at least.