Comparison of the Effects of Contralaterally Controlled Functional Electrical Stimulation and Neuromuscular Electrical Stimulation on Upper Extremity Functions in Patients with Stroke

Shen, Ying; Yin, Zhifei; Fan, Yong; Chen, Chiun-Fan; Dai, Wenjun; Yi, Wenchao; Li, Yongqiang; Zhang, Wentong; Zhang, Yuting; Bian, Rong; Huang, Yan; Machado, Sérgio; Yuan, Ti‐Fei; Shan, Chunlei

doi:10.2174/1871527315666151111122457

Cited by 26 publications

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“…The study was powered based on data from Knutson et al (9) to detect differences in upper extremity FMA mean scores of 46.2 (standard deviation (SD) 2.1) in the CCFES group vs 41.1 (SD 2.2) in the NMES group at a significance level of 0.05 (10). A minimum of 4 participants per group was required in order to detect differences between groups with a power of 90%.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, CCFES has been developed as an active training, involving repetitive stimulation of peripheral neural activity, with bilateral symmetrical movement on the non-paretic side, to produce symmetrical and near-simultaneous movement of the paretic side. The patients control the timing and degree of WD in a way that does not interfere with the fluidity of task practice, making it more conducive to complete task-oriented functional hand activities (9,10,17). The effectiveness of CCFES was investigated in a RCT study conducted by Knutson et al in 2016 (17).…”

Section: Discussionmentioning

confidence: 99%

“…As described by Knutson et al, "CCFES uses a control signal from the nonparetic side of the body to regulate the intensity of electrical stimulation delivered to the paretic muscles of the homologous limb on the opposite side of the body" (8). In separate studies, Knutson et al (9) and Shen et al (10) compared the effectiveness of CCFES and NMES in patients with sub-acute stoke, and found greater improvements with CCFES. Nonetheless, its effectiveness in the early-phase (i.e.…”

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confidence: 99%

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Contralaterally controlled functional electrical stimulation improves wrist dorsiflexion and upper limb function in patients with early-phase stroke: A randomized controlled trial

Zheng¹,

Mao²,

Cao³

et al. 2019

J Rehabil Med

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After a stroke, it is essential that recovery of function of the upper limb is maximized in order to enable activities of daily living. The hand plays an important role in the function of the upper limb. This study examined the effectiveness of contralaterally controlled functional electrical stimulation (CCFES) on recovery of active dorsiflexion of the wrist and upper limb functioning in patients in the early-phase after stroke (<15 days post-stroke). CCFES significantly shortened the time for regaining wrist dorsiflexion, and improved the upper extremity function and general health of patients with early-phase stroke, compared with conventional neuro muscular electrical stimulation. CCFES therefore has potential as a clinical intervention. Objectives: To investigate the effectiveness of contra laterally controlled functional electrical stimulation (CCFES) on the recovery of active wrist dorsiflexion and upper limb function in patients with early-phase stroke (<15 days poststroke). Methods: Patients in the CCFES group were treated with routine rehabilitation combined with CCFES, while those in the conventional neuromuscular electrical stimulation (NMES) group were treated with routine rehabilitation combined with NMES. Time intervals from stroke onset to appearance of wrist dorsiflexion, and from onset of treatment to appearance of wrist dorsiflexion were recorded (in days). Functional assessments were also performed at baseline and endpoint. Results: Nineteen out of 21 patients in the CCFES group and 12 out of 20 patients in the NMES group regained active wrist dorsiflexion during the treatment and follow-up period (90.5% vs 60%, p = 0.025). The mean time interval from onset of treatment to appearance of active wrist dorsiflexion was signifcantly shorter in the CCFES group than in the NMES group (p < 0.001). The CCFES group had signifcantly higher scores for upper extremity function (p = 0.001), strength of extensor carpi (p = 0.002), active ROM for wrist dorsiflexion (p = 0.003), activities of daily living score (p = 0.023) and ICF score (p < 0.001) than the NMES group at the endpoint. Conclusion: CCFES signifcantly shortened the time for regaining wrist dorsiflexion, and improved the upper extremity function and general health of patients with early-phase stroke. CCFES therefore has potential as a clinical intervention.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Contralaterally controlled functional electrical stimulation improves wrist dorsiflexion and upper limb function in patients with early-phase stroke: A randomized controlled trial

Zheng¹,

Mao²,

Cao³

et al. 2019

J Rehabil Med

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“…16 Recently, other investigators compared a variation of CCFES to cNMES in patients ≤ 3 months post-stroke (n=60), and showed that CCFES produced significantly greater gains than cNMES. 25 Unlike these previous trials, the present study included only stroke survivors with chronic hemiplegia (> 6 months), a population for which it is even more challenging to show positive benefits of rehabilitative therapy.…”

Section: Discussionmentioning

confidence: 99%

Contralaterally Controlled Functional Electrical Stimulation Improves Hand Dexterity in Chronic Hemiparesis

Knutson

Gunzler

Wilson

et al. 2016

Stroke

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Background and Purpose It is unknown whether one method of neuromuscular stimulation for post-stroke upper limb rehabilitation is more effective than another. Our aim was to compare the effects of contralaterally controlled functional electrical stimulation (CCFES) to cyclic neuromuscular electrical stimulation (cNMES). Methods Stroke patients with chronic (> 6 months) moderate to severe upper extremity hemiparesis (n=80) were randomized to receive 10 sessions/week of CCFES- or cNMES-assisted hand opening exercise at home plus 20 sessions of functional task practice in the lab over 12 weeks. The task practice for the CCFES group was stimulation-assisted. The primary outcome was change in Box and Blocks Test (BBT) score at 6-months post-treatment. Upper extremity Fugl-Meyer (UEFM) and Arm Motor Abilities Test (AMAT) were also measured. Results At 6-months post-treatment, the CCFES group had greater improvement on the BBT, 4.6 (95% CI: 2.2, 7.0), than the cNMES group, 1.8 (95% CI: 0.6, 3.0); between-group difference, 2.8 (95% CI: 0.1, 5.5), p=0.045. No significant between-group difference was found for the UEFM (p=.888) or AMAT (p=.096). Participants who had the largest improvements on BBT were less than two years post-stroke with moderate (i.e., not severe) hand impairment at baseline. Among these, the 6-month post-treatment BBT gains of the CCFES group, 9.6 (95% CI: 5.6, 13.6), were greater than those of the cNMES group, 4.1 (95% CI: 1.7, 6.5); between-group difference, 5.5 (95% CI: 0.8, 10.2), p=0.023. Conclusions CCFES improved hand dexterity more than cNMES in chronic stroke survivors. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT00891319.

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“…Hospital of Nanjing Medical University, Nanjing, China E-mail: zhengyu8710@163.com it was safe for patients' skin (6). Knutson et al applied a pulse amplitude of 40 mA for all patients and 60 mA for one participant (7)(8)(9).…”

Section: Department Of Rehabilitation Medicine the First Affiliatedmentioning

confidence: 99%

Comments to: ”Contralaterally controlled functional electrical stimulation improves wrist dorsiflexion un upper limb function in patients with early-phase stroke: A randomized controlled trial?”

Jhandi¹,

Goyal²,

Tiwari³

2019

J Rehabil Med

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Comparison of the Effects of Contralaterally Controlled Functional Electrical Stimulation and Neuromuscular Electrical Stimulation on Upper Extremity Functions in Patients with Stroke

Abstract: Compared with the conventional NMES, CCFES provides better recovery of upper extremity function in patients with stroke.

Cited by 26 publications

References 0 publications

Contralaterally controlled functional electrical stimulation improves wrist dorsiflexion and upper limb function in patients with early-phase stroke: A randomized controlled trial

Contralaterally controlled functional electrical stimulation improves wrist dorsiflexion and upper limb function in patients with early-phase stroke: A randomized controlled trial

Contralaterally Controlled Functional Electrical Stimulation Improves Hand Dexterity in Chronic Hemiparesis

Comments to: ”Contralaterally controlled functional electrical stimulation improves wrist dorsiflexion un upper limb function in patients with early-phase stroke: A randomized controlled trial?”

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