Influence of Electrotherapy with Task-Oriented Training on Spasticity, Hand Function, Upper Limb Function, and Activities of Daily Living in Patients with Subacute Stroke: A Double-Blinded, Randomized, Controlled Trial.

Jong-Hoon Moon,Hwi-Young Cho,Suk-Chan Hahm

doi:10.3390/healthcare9080987

Abstract

The effects of electrotherapy with task-oriented training on upper limb function in subacute stroke patients are unclear. This study investigated the influence of transcutaneous electrical nerve stimulation (TENS) with task-oriented training on spasticity, hand function, upper limb function, and activities of daily living in patients with subacute stroke. Forty-eight patients with subacute stroke were randomly assigned to either the TENS group (n = 22) or the placebo-TENS group (n = 21). High-frequency (100 Hz) TENS with below-motor threshold intensity or placebo-TENS was applied for 30 min/day, five times a week, for 4 weeks. The two groups also received task-oriented training after TENS. The Modified Ashworth Scale (MAS), Jebsen–Taylor Hand Function Test (JTHFT), Manual Function Test (MFT), and Modified Barthel Index (MBI) were used to assess spasticity, hand function, upper limb function, and activities of daily living, respectively. There was a significant time–group interaction with the MFT (p = 0.003). The TENS group showed significantly improved MAS (p = 0.003), JTHFT (p < 0.001), MFT (p < 0.001), and MBI (p < 0.001) scores after the intervention. The placebo-TENS group showed significantly improved JTHFT (p < 0.001), MFT (p = 0.001), and MBI scores (p < 0.001). There was a significant correlation between the MFT and MBI scores (p = 0.025). These results suggest that electrotherapy with task-oriented training can be used to improve upper limb function in patients with subacute stroke.

Highlights

Stroke is a disease that involves sensory, motor, cognitive, and speech disabilities due to cerebral blood vessel disease [1]
There were no significant differences in the general characteristics or in the Modified Ashworth Scale (MAS), Jebsen–Taylor Hand Function Test (JHFT), Manual Function Test (MFT), and Modified Barthel Index (MBI) scores between the two groups
This study investigated the influence of Transcutaneous electrical nerve stimulation (TENS) with task-oriented training on spasticity, hand function, upper limb function, and activities of daily living in patients with subacute stroke

Summary

Introduction

Stroke is a disease that involves sensory, motor, cognitive, and speech disabilities due to cerebral blood vessel disease [1]. Disabilities in upper limb function, including hand function, lead to limitations in activities of daily living [2]. Improving upper limb function and activities of daily living is an important goal of rehabilitation for patients with stroke [3]. Levin and Hui-Chan reported that TENS can reduce spasticity and improve motor function in patients with stroke [5]. These effects may be due to the plastic changes in the brain caused by the application and enhancement of TENS in the reciprocal inhibition of concentric and eccentric muscles via disinhibition of the upper motor neurons [5,6,7]

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