Neuromuscular Electric Stimulation in Addition to Exercise Therapy in Patients with Lower Extremity Paresis Due to Acute Ischemic Stroke. A proof-of-concept randomised controlled trial

Background: Transcranial magnetic stimulation (TMS) is often used to examine neurophysiology. We aimed to investigate the inter-rater reliability and agreement of single pulse TMS in hospitalised acute ischemic stroke patients. Methods: Thirty-one patients with first-time acute ischemic stroke (median age 72 (IQR 64-75), 35% females) underwent TMS motor threshold (MT) assessment in 4 muscles bilaterally, conducted by 1 of 2 physiotherapists. Test-retest reliability was evaluated using a two-way random effects model (2,1) absolute agreement-type Interclass Correlation Coefficient (ICC). Standard Error of Measurement (SEM) and Smallest Detectable Change (SDC) were used to evaluate agreement. Results: Reliability, SEM, and SDC of TMS was found to be moderate in right opponens pollicis (0.78 [CI 95% 0.55-0.89], SEM: 4.51, SDC: 12.51), good in right vastus medialis and tibial anterior (0.88 [CI 95% 0.72-0.96], SEM: 2.89, SDC: 8.01 and 0.88 [CI 95% 0.76-0.94], SEM: 2.88, SDC: 7.98 respectively), and excellent in right and left biceps brachii (0.98 [CI 95% 0.96-0.99], SEM: 1.79 SDC: 4.96, and 0.94 [CI 95% 0.89-0.97], SEM: 2.17 SDC: 6.01), opponens pollicis (0.92 [CI 95% 0.83-0.96], SEM: 2.68 SDC: 8.26, vastus medialis (0.92 [CI 95% 0.84-0.96], SEM: 2.87 SDC: 7.95), and tibial anterior (0.93 [CI 95% 0.86-0.96], SEM: 2.51 SDC: 6.95). Conclusion: The TMS demonstrated moderate to excellent inter-rater reliability confirming the ability of these measures to reliably discriminate between individuals in the current study sample. Improvements of less than 4.96 to 12.51 could be a result of measurement error and may therefore not be considered a true change.

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Test-Retest Reliability and Agreement of Single Pulse Transcranial Magnetic Stimulation (TMS) for Measuring Activity in Motor Cortex in Patients With Acute Ischemic Stroke

Busk

Marianne

Rønne

et al. 2022

J Exp Neurosci

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Rehabilitative effects of electrical stimulation on gait performance in stroke patients: A systematic review with meta-analysis

Hwang,

Song

2024

NRE

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BACKGROUND: Electrical stimulation techniques are widely utilized for rehabilitation management in individuals with stroke patients. OBJECTIVES: This review aims to summarize the rehabilitative effects of electrical stimulation therapy on gait performance in stroke patients. METHODS: This review included randomized controlled trials (RCT) investigating the therapeutic effects of electrical stimulation in stroke patients throughout five databases. This review qualitatively synthesized 20 studies and quantitatively analyzed 11 RCTs. RESULTS: Functional electrical stimulation (FES) was the most commonly used electrical stimulation type to improve postural stability and gait performance in stroke patients. The clinical measurement tools commonly used in the three studies to assess the therapeutic effects of FES were Berg balance scale (BBS), 10-meter walk test (10MWT), 6-minute walk test (6mWT), and gait velocity. The BBS score and gait velocity had positive effects in the FES group compared with the control group, but the 10MWT and 6mWT showed the same effects between the two groups. The heterogeneity of BBS scores was also high. CONCLUSION: The results of this review suggest that electrical stimulation shows little evidence of postural stability and gait performance in stroke patients, although some electrical stimulations showed positive effects on postural stability and gait performance.

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Neuromuscular Electric Stimulation in Addition to Exercise Therapy in Patients with Lower Extremity Paresis Due to Acute Ischemic Stroke. A proof-of-concept randomised controlled trial

Cited by 2 publications

References 58 publications

Test-Retest Reliability and Agreement of Single Pulse Transcranial Magnetic Stimulation (TMS) for Measuring Activity in Motor Cortex in Patients With Acute Ischemic Stroke

Test-Retest Reliability and Agreement of Single Pulse Transcranial Magnetic Stimulation (TMS) for Measuring Activity in Motor Cortex in Patients With Acute Ischemic Stroke

Rehabilitative effects of electrical stimulation on gait performance in stroke patients: A systematic review with meta-analysis

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