Response to Letter by Page and Chae

Abstract

Response: We would challenge the view of Professors Page and Chae that our study is seriously flawed. The study is a pragmatic clinical trial to answer a clinically relevant question—does surface neuromuscular electrical stimulation (sNMES) applied to the shoulder within 10 days of stroke improve upper limb function?1 Features of the study include a placebo-control blinded-outcome assessment and measurement of carryover effect. The study has adequate statistical power. During rehabilitation, stroke patients wish to regain useful upper limb function. As Page and Chae rightly point out, sNMES has been shown to improve glenohumeral subluxation and range of movement but it should not be assumed that this translates into sustained functional benefits or important clinical gain.2–4 Because our research question related to upper limb function, it was appropriate to use the Action Research Arm Test, which is a validated measure of arm function, as the primary outcome measure. Page and Chae wrongly state …