Conjunct Effects of Supported Standing and Functional Electrical Stimulation on Strength and Functional Mobility in Acute Stroke: A Randomized Clinical Trial

Abstract

Background: After an acute stroke, many patients face difficulty while performing activities of daily living. Supported standing is used for the early mobilization of patients with stroke. The use of functional electrical stimulation is an adjunct component of rehabilitation to augment the strength of lower limbs resulting in better trunk control during functional mobility. Combined effects of electrical stimulation with early weight-bearing exercises can be an effective treatment as compared to typical conventional post-stroke rehabilitation. Objective: To evaluate the conjunct effects of supported standing and functional electrical stimulation on strength and functional mobility in acute stroke. Methods: A single-blinded randomized clinical trial was conducted from March to September 2021. Participants aged between 30 to 65 years, both gender, after fulfilling the inclusion criteria were allocated randomly into two groups (32 patients per group). The conventional therapy included positioning, ROM exercises and bed mobility exercises along with supporting standing on tilt tables initially and later on standing frames and walkers for 30 minutes/day five times per week, for almost six weeks while the experimental group received functional electrical stimulation in standing position on the tilt table in addition to conventional therapy. The trial was registered in the Iranian Registry of Clinical Trials and was approved by the ethics committee of Riphah International University. The data was analyzed using SPSS version 24 and for descriptive analysis, mean and standard deviation were used for numerical continuous variables while categorical variables were presented by frequencies, percentages and median (IQR). Independent sample t-test was applied for the comparison between both groups in quantitative variables, whereas the chi-square test and Fisher Exact test were used for qualitative variables at baseline (Table I). Non-parametric Mann-Whitney U test and Wilcoxon Signed Rank test was applied to assess the average difference between and within group comparison. Results: The findings showed that the score of all scales were statistically significant for both within and between the groups (p-value<0.001). Conclusion: It was concluded that supported standing technique along with functional electrical stimulation and conventional physical therapy was found to be more effective in improving functional mobility, balance and strength among acute stroke patients rather than standard physical therapy alone.