Electrical stimulation of wrist and fingers for sensory and functional recovery in acute hemiplegia

Abstract

The results of this study indicated that additional stimulation of the hand and fingers leads to an improved sensorimotor outcome immediately after the intervention.

Functional Electrical Stimulation Enhancement of Upper Extremity Functional Recovery During Stroke Rehabilitation: A Pilot Study

“…A third possible shortcoming is the research paradigm of using NMES without the addition of volitional, task-specific functional training. [10][11][12][13]16,17,19,22,25 This separation has no apparent conceptual or evidence-based support. A few case-series 14,15,27 and a randomized controlled clinical trial that included 22 patients 21 combined the stimulation with both unimanual and bimanual task-oriented functional activities.…”

“…Intervention studies to improve upper extremity recovery following stroke include increasing exercise duration and intensity, [3][4][5][6][7] focusing on task-specific training, 8,9 and enhancing training by surface neuromuscular electrical nerve stimulation. [10][11][12][13][14][15][16][17][18][19][20][21][22] The clinical efficacy, as well as a number of inherent difficulties associated with the various therapeutic intervention options following stroke in general and upper extremity paralysis/paresis in particular, were recently reviewed. 23 Intense and taskoriented training was found to yield better upper extremity control, particularly in patients who demonstrated at least modest motor control prior to entering into a clinical trial.…”

Tactile stimulation interventions: Influence of stimulation parameters on sensorimotor behavior and neurophysiological correlates in healthy and clinical samples

“…Exemplarily 1.7 Hz TENS just above the somatosensory threshold, which is rather similar to single pulse stimulation, improved the movement velocity of the wrist, fingers and hand (Koesler, Dafotakis, Ameli, Fink, & Nowak, 2009). Also repeated electrical stimulation at 2 Hz and muscle intensity for 1 hour at 10 days, which is comparable to the parameters applied in whole hand stimulation protocols, improved the effects of this motor training on kinesthesia sense, hand functioning and hand movement (Yozbatiran, Donmez, Kayak, & Bozan, 2006 (Powell, Pandyan, Granat, Cameron, & Stott, 1999).…”

“…However, the results of studies assessing general measures of paralysis also show that lower frequency stimulation can influence some measures, like wrist extension, hand functioning and kinesthesia sense (Koesler et al, 2009;Yozbatiran et al, 2006).…”

“…Hereby TENS failed to influence measures of dexterity, like peak wrist position or aperture and the amplitudes of finger tapping (Koesler et al, 2009). Additionally, after 2 Hz stimulation at muscle intensity, the ability to perform isolated digit movements did not improve more than after motor exercises (Yozbatiran et al, 2006). Nevertheless, there are multiple evidences for improved fine motor coordination through rTS, such as the assessment of grasping abilities.…”