The effects of task-oriented electromyography-triggered stimulation on the hand functions of subacute stroke patients

Abstract

The aim of present study was to investigate the effects of electromyography (EMG) — triggered neuromuscular stimulation (NMES) when combined with specific tasks for hand function recovery in stroke patients who have functional disabilities in the upper extremity. A total of 30 subacute stroke patients were randomly allocated into one of the three groups: task-oriented EMG-triggered NMES group (El, n=10), task-oriented NMES group (E2, n=10), and control group (C, n=10). The patients in El group was trained with EMG-triggered NMES which was synchronized with a rehabilitative gaming system and two other tasks for 30 minutes a day, 5 times a week for 5 weeks, and E2 group was trained with NMES with the same tasks as El group for the same amount of time. Data collection included premotor reaction time (RT) of extensor carpi ulnaris (ECU) on EMG, Fugl-Meyer Assessment for the upper extremity (FMA), Motor Assessment Scale for the upper limb (MAS), and Box and Block test (B&B) before and after the intervention. El group showed a significant improvement in hand functions compared to E2 and the control group: premotor RT of ECU was significantly decreased, total scores of FMA and MAS were significantly increased, and number of blocks moved in B&B were significantly increased after the intervention (p<.05). Present study demonstrated that task-oriented EMG-triggered NMES training in subacute stroke patients can effectively improve the paretic hand functions compared to task-oriented NMES training. Therefore, the use of task-oriented EMG-triggered NMES can be applied and included in the future rehabilitation program for the stroke patients who have restricted use of the hands. The findings in this study extend the evidence favoring both the motor and functional improvements for the paretic hand of subacute stroke patients.