Abstract
The available data from electroneurography (ENG) studies on the transmission of neural impulses in the motor fibers of upper and lower extremity nerves following neuromuscular functional electrical stimulation (NMFES) combined with kinesiotherapy in post-stroke patients during sixty-day observation do not provide convincing results. This study aims to compare the effectiveness of an NMFES of antagonistic muscle groups at the wrist and ankle and kinesiotherapy based mainly on proprioceptive neuromuscular facilitation (PNF). An ENG was performed once in a group of 60 healthy volunteers and three times in 120 patients after stroke (T0, up to 7 days after the incident; T1, after 21 days of treatment; and T2, after 60 days of treatment); 60 subjects received personalized NMFES and PNF treatment (NMFES+K), while the other 60 received only PNF (K). An ENG studied peripheral (M-wave recordings), C8 and L5 ventral root (F-wave recordings) neural impulse transmission in the peroneal and the ulnar nerves on the hemiparetic side. Both groups statistically differed in their amplitudes of M-wave recording parameters after peroneal nerve stimulation performed at T0 and T2 compared with the control group. After 60 days of treatment, only the patients from the NMFES+K group showed significant improvement in M-wave recordings. The application of the proposed NMFES electrostimulation algorithm combined with PNF improved the peripheral neural transmission in peroneal but not ulnar motor nerve fibers in patients after ischemic stroke. Combined kinesiotherapy and safe, personalized, controlled electrotherapy after stroke give better results than kinesiotherapy alone.
Highlights
Successful rehabilitation of patients after ischemic stroke consists of pharmacological treatment [1] and kinesiotherapeutic procedures based on the proprioceptive neuromuscular facilitation (PNF) method performed by physiotherapists according to the worldwide accepted algorithm [2,3,4]
Of the 133 patients, 67 who agreed to participate in the project with electrotherapy procedures and did not present contraindications for electrostimulation were recruited to the neuromuscular functional electrical stimulation (NMFES)+K group treated with kinesiotherapy and muscle electrotherapy under the supervision of a team of the physical and rehabilitation medicine physician and the physiotherapist
Only Lisiński et Lisiński et al [6] has proven the effectiveness of a rehabilitation therapy evaluated usal. [6] has proven the effectiveness of a rehabilitation therapy evaluated using neurophysing neurophysiology methods, such as electroneurography, on the transmission of nerve iology methods, such as electroneurography, on the transmission of nerve impulses in impulses in upper and lower extremities but only in a 20-day observation
Summary
Successful rehabilitation of patients after ischemic stroke consists of pharmacological treatment [1] and kinesiotherapeutic procedures based on the proprioceptive neuromuscular facilitation (PNF) method performed by physiotherapists according to the worldwide accepted algorithm [2,3,4]. Physical therapy applied to post-stroke patients consists mainly of therapy based on warming and electrotherapy of the paretic muscles. The aim is to improve the activity of the motor units undergoing pathological neurogenic change. Current trends in electrotherapy focus on the functional electrical stimulation of nerves (FES), and neuromuscular functional electrical stimulation (NMFES). Various combinations of stimuli algorithms have proven to be moderately effective [5]. NMFES can be applied to the muscles acting antagonistically at the wrist and ankle joints in post-stroke patients, as
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