Spasticity management is pivotal for achieving functional recovery of stroke patients. The purpose of this study was to investigate the effects of a single trial of transcutaneous electrical nerve stimulation (TENS) on spasticity and balance in chronic stroke patients. Forty-two chronic stroke patients were randomly allocated into the TENS (n = 22) or the placebo-TENS (n = 20) group. TENS stimulation was applied to the gastrocnemius for 60 min at 100 Hz, 200 µs with 2 to 3 times the sensory threshold (the minimal threshold in detecting electrical stimulation for subjects) after received physical therapy for 30 min. In the placebo-TENS group, electrodes were placed but no electrical stimulation was administered. For measuring spasticity, the resistance encountered during passive muscle stretching of ankle joint was assessed using the Modified Ashworth Scale, and the Hand held dynamometer was used to assess the resistive force caused by spasticity. Balance ability was measured using a force platform that measures postural sway generated by postural imbalance. The TENS group showed a significantly greater reduction in spasticity of the gastrocnemius, compared to the placebo-TENS group (p < 0.05). TENS resulted in greater balance ability improvements, especially during the eyes closed condition (p < 0.05). However, these effects returned to baseline values within one day. This study shows that TENS provides an immediately effective means of reducing spasticity and of improving balance in chronic stroke patients. The present data may be useful to establish the standard parameters for TENS application in the clinical setting of stroke.

Abstract.[Purpose] The main purpose of this study was to investigate the effects of Virtual Reality Reflection Therapy on motor recovery and motor function in the upper extremities of patients with chronic stroke. [Subjects] Nineteen participants patients with chronic stroke were randomly assigned to the experimental group (n=11) and the control group (n=8).[Methods] The experimental group performed a Virtual Reality Reflection Therapy program for 30 minutes a day, 5 days a week, during a 4 week period, in addition to conventional therapy. The control group received conventional therapy and performed sham program. All subjects were evaluated using by the Fugl-Meyer Assessment (upper limb section), the Modified Ashworth Scale (MAS), the Box and Block Test (BBT), the JebsenTaylor Hand Function Test and the Manual Function Test pre-and post-intervention.[Results] The experimental group and the control group effectively increased their upper-extremity motor recovery and motor function. Upperextremity motor recovery and motor function of the experimental group showed more significant increases than those of the control group.[Conclusion] Virtual Reality Reflection Therapy (even as a home treatment) with a conventional program in the early stages of treatment might be beneficial for improving hand function. Future studies need to investigate the effectiveness of Virtual Reality Reflection Therapy with optimal patient selection or duration and intensity of training.

Severe upper limb paresis is a major contributor to disability after stroke. This study investigated the efficacy of task-related training (TRT) with transcutaneous electrical nerve stimulation (TENS) on recovery of upper limb motor function in chronic-stroke survivors. Thirty patients with chronic stroke were randomly allocated two groups: the TRT+TENS group (n = 15) and the TRT+placebo (TRT+PLBO) group (n = 15). Patients in the TRT+TENS group received TENS stimulation (two to three times the sensory threshold), while subjects in the TRT+PLBO group received TENS without real electrical stimulation. TENS was applied to muscle belly of triceps and wrist extensors, while placebo (PLBO) stimulation was administrated without real electrical stimulation. Both interventions were given for 30 minutes per day, 5 days per week, for a period of 4 weeks. The primary outcomes were assessed with Fugl-Meyer assessment scores (FMA), Manual function test (MFT), Box and block test (BBT), and Modified Ashworth scale (MAS), each of which was performed one day before and one day after intervention. Both groups showed significant improvements in FMA, MFT, and BBT after intervention. When compared with the TRT+PLBO group, the TRT+TENS group showed significantly greater improvements in FMA (p = 0.034), MFT (p = 0.037), and BBT (p = 0.042). In MAS score, significant improvement was observed only in the TRT+TENS group (p = 0.011). Our findings indicate that TRT with TENS can reduce motor impairment and improve motor activity in stroke survivors with chronic upper limb paresis, highlighting the benefits of somatosensory stimulation from TENS.

Abstract.[Purpose] The purpose of this study was to investigate the effects of transcutaneous electrical stimulation (TENS) applied to fatigued muscles on postural imbalance and decline in muscle strength following fatigue of the gastrocnemius.[Subjects] Eighteen subjects with muscle fatigue were allocated to either a sensory threshold group or a 2~3 times sensory threshold group and the study followed a randomized single-blind cross-over design.[Methods] Muscle fatigue of the gastrocnemius was induced by repeated exercise. After inducing fatigue, TENS was applied to the fatigued muscle. The postural sway length (PSL), postural sway velocity (PSV) and maximal voluntary contraction (MVC) were measured before and after the induction of fatigue, and during the application of TENS to the fatigued muscles.[Results] Muscle fatigue increased postural imbalance as expressed by length and velocity of body sway and decreased muscle strength, while TENS improved the postural imbalance and partially reversed the muscle strength decline induced by muscle fatigue.[Conclusion] Muscle fatigue is an important factor in postural balance control and muscle voluntary contraction, and TENS can be effective at relieving muscle fatigue.

No abstract