Transcutaneous Electrical Nerve Stimulation in Conjunction with Task-oriented Training in the Management of Chronic Post-stroke Spasticity of the Upper Limb: A Case Report

Background: Post-stroke spasticity is a major contributor to functional impairment and disability among stroke survivors as it negatively affects recovery and interferes with quality of life. Case presentation: We present a 45-year-old man with a 6-year history of stroke affecting the right side of the body. He presented with chronic upper limb spasticity and walk with hemiplegic gait without support. The patient received Transcutaneous Electrical Nerve Stimulation (TENS) to the belly of elbow flexors of the right upper limb using a frequency of 100HZ and pulse duration of 200μs for 60 minutes. Six sets of 100 repetitions of task-oriented training were also performed for 60 minutes. All treatments were administered twice weekly for 12 weeks. The patient’s spasticity and motor function were assessed using Modified Ashworth Scale (MAS) and Brunnstrom Recovery Stages (BRS), respectively, before treatment, and 6 weeks and 12 weeks post treatment. There was reduction in spasticity post treatment with more reduction being recorded at 12 weeks. The patient’s motor function also improved post treatment but no difference was observed between the 6 weeks and 12 weeks of treatment. Conclusions: The findings of this study demonstrated the beneficial effect of TENS in conjunction with task-oriented training in reducing chronic post-stroke spasticity and motor function of the upper limb.