Poster 39: Is There Credible Medical Evidence To Delay Functional Electric Stimulation in Stroke Rehabilitation?

Abstract

Objective: To test the hypothesis that early commencement and prolonged functional electric stimulation (FES) training will not interfere with upper-limb recovery or cause increase incidence of adverse responses. Design: Randomized, controlled pilot study. Setting: Acute rehabilitation center. Participants: Ischemic stroke, stratified by severity of motor loss, randomly assigned to control (n=8) or FES (n=8) groups. Interventions: Both groups received task-specific uni- and bimanual exercise program, and the FES group received electric stimulation to the wrist and fingers extensors and flexors combined with exercise program. Main Outcome Measures: Modified Fugl-Meyer Assessment (FMA) for the upper limb, recovery of hand function, and adverse events. Measurements were taken at baseline 4, 8, and 12 weeks. Results: Analysis of variance (P=.05) revealed a similar trend of recovery in both groups. The control group’s FMA score at 12 weeks was 23.7±18.4 points versus the FES group’s 38.1±15.7 points. Box and block test scores were 11.8±16.3 and 26.1±22.5 blocks for the control and FES groups, respectively. A similar trend favoring the FES (22.4±24.3s) versus control (45.3±25.2s) groups was found for the Jebsen-Taylor Hand Function Test, recurrent stroke, shoulder pain, and shoulder subluxation; they provided evidence that upper-limb recovery is not adversely affected by FES. Conclusions: Delaying FES training cannot be justified by credible medical evidence.