The efficacy of electrical stimulation in reducing the post-stroke spasticity: a randomized controlled study

Abstract

Purpose: The purpose of this study is to evaluate the efficacy of surface electrical stimulation on the spasticity occurring in the wrist flexor muscles after a cerebrovascular event. Method: Hemiplegic patients with stage 2–3 spasticity in the wrist muscles based on the Ashworth scale were divided into two groups. Both groups were applied stretching. One group was additionally administered neuromuscular electrical stimulation (NMES) to the wrist extensors, in the form of pulsed current, 100 Hz, with a pulse duration of 0.1 msec, and a resting duration of 9 seconds, for 15 minutes to provide the maximum muscular contraction. The efficacy of the treatment was evaluated using the following: modified Ashworth scale (MAS), Fmax/Mmax ratio, Hmax/Mmax ratio, wrist extension range of motion (ROM). The daily activities were assessed by Functional Independence Measurement (FIM) and the motor recovery was evaluated by Brunnstrom motor staging. Results: Both groups revealed a significant recovery after the treatment based on the MAS, the electrophysiological evaluation results, wrist ROM, FIM and Brunnstrom motor staging. The group receiving the combined treatment showed a better recovery in terms of MAS, wrist ROM, FIM and Brunnstrom motor staging compared to the group doing the stretching alone. Conclusions: The results of this study showed that NMES given together with stretching of the wrist extensor muscles was more effective than stretching of the wrist extensor muscles alone in reducing spasticity.

Implications for Rehabilitation

• There is a wide range of treatment options for spasticity, from conservative treatments (medications, splint, physical treatment modalities, and exercise) to surgery.

• The efficacy of electrical stimulation in spasticity is still controversial.

• Electrical stimulation treatment applied together with wrist extensor muscles passive stretching exercise is effective in reducing spasticity.

Keywords::

• electrical stimulation
• spasticity
• stretching
• stroke

Declaration of interest: The authors report no conflicts of interest.