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

Abstract

To investigate the effectiveness of contralaterally controlled functional electrical stimulation (CCFES) on wrist dorsiflexion (WD) and upper limb function in patients with early-phase stroke. Eligible patients were randomly assigned into two study groups. Patients in the CCFES group were treated with routine rehabilitation combined with CCFES while those in the neuromuscular electrical stimulation (NMES) group were treated with routine rehabilitation combined with NMES. The time intervals from the onset of stroke to the appearance of WD and from the onset of treatment to the appearance of WD were recorded. The functional assessments, including active range of motion for WD, strength of extensor carpi, Fugl-Meyer assessment (FMA) for upper extremity, Jebsen Hand Function Test (JHFT), modified Barthel Index (mBI) and ICF Generic Set, were performed at baseline and endpoint. Nineteen patients (90.48%) in CCFES group and 12 patients (60%) in NMES group were observed to obtain the active WD during the treatment period. The time interval from the onset of stroke to the appearance of active WD was significantly earlier in CCFES group (18.33 ± 7.01 days) as compared to that in NMES group (40.95 ± 20.02 days). For inter-group comparison, statistical differences were observed for all the items except JHFT at the endpoint. Changes between baseline and endpoint for each parameter were significantly different between groups. For intra-group comparison, the scores obtained at the endpoint were significantly higher than that of baseline. CCFES was superior to NMES in either shortening the course of WD appearance and the recovery of upper extremity function in patients with early-phase stroke.