Neuromuscular Electrical Stimulation of the Muscles Surrounding the Shoulder

Abstract

Neuromuscular electrical stimulation (NMES) can be used to augment range-of-motion, strengthening, and facilitation treatment programs of the muscles surrounding the shoulder. The purposes of this article are 1) to describe the uses of NMES around the shoulder joint as developed through our clinical use and 2) to detail the effects of an NMES program on chronic shoulder subluxation as determined by a clinical study. Because of the complexities of this multiarticular joint, NMES is most useful in the initial phase of the ROM, and stimulated contractions are compromised, relatively, as the humerus moves above the 90-degree horizontal plane. The use of NMES to provide scapular stabilization often entails unwanted alteration of the pressures on the spinal column, occasionally making the treatment program unusable. Electrical stimulation to prevent or correct shoulder subluxation, especially in the neurologically involved patient, provides the therapist with a powerful new treatment technique. In a group of stroke patients, shoulder subluxation was reduced significantly (p less than .05) at the completion of a six-week NMES program. Some of the problems, and possible solutions, unique to the development of electrical stimulation programs for the shoulder muscles are discussed.

Treatment of hemiplegic shoulder pain in the Netherlands: results of a national survey

“…There were 91 nonrespondents. Another 58 questionnaires were returned, but excluded from the analysis for the following reasons: no patients with hemiplegic shoulder pain treated during the previous 12 months (39), questionnaire filled in at a different work address (4), retired (2), no longer working at the same address (1), reason unknown (12). Table 1 presents the response rates and general characteristics of the respondents.…”

Neuromuscular electrical stimulation in neurorehabilitation

“…There are nine controlled clinical trials of transcutaneous NMES for the treatment of hemiplegic shoulder pain in the literature. 15,61,62,95,161,179,188,297,298 The two publications by Wang et al 297,298 include separate trials for acute and chronic stroke survivors and the two studies report different outcomes from the same study. Seven studies evaluated NMES as a treatment modality, 15,61,62,161,179,297,298 one evaluated prevention 188 and one evaluated a combination of treatment and prevention.…”

“…15,61,62,95,161,179,188,297,298 The two publications by Wang et al 297,298 include separate trials for acute and chronic stroke survivors and the two studies report different outcomes from the same study. Seven studies evaluated NMES as a treatment modality, 15,61,62,161,179,297,298 one evaluated prevention 188 and one evaluated a combination of treatment and prevention. 95 Five studies evaluated acute stroke survivors, 61,62,95,188,297,298 two studies evaluated a combination of acute and chronic stroke survivors, 15,179 and two studies evaluated chronic stroke survivors.…”

“…Seven studies evaluated NMES as a treatment modality, 15,61,62,161,179,297,298 one evaluated prevention 188 and one evaluated a combination of treatment and prevention. 95 Five studies evaluated acute stroke survivors, 61,62,95,188,297,298 two studies evaluated a combination of acute and chronic stroke survivors, 15,179 and two studies evaluated chronic stroke survivors. 161,297,298 Radiographic glenohumeral subluxation is the most consistently evaluated outcome measure.…”

Prevention of Shoulder Subluxation After Stroke With Electrical Stimulation

“…6 -9 In view of the shortcomings associated with the use of slings, alternative approaches to deal with this problem have been sought. Two studies 10,11 have investigated the application of electrical stimulation to the supraspinatus and posterior deltoid muscles.…”