Abstract
Neuromuscular stimulation has been used as one potential rehabilitative treatment option to restore motor function and improve recovery in patients with paresis. Especially stroke patients who often regain only limited hand function would greatly benefit from a therapy that enhances recovery and restores movement. Multiple studies investigated the effect of functional electrical stimulation on hand paresis, the results however are inconsistent. Here we review the current literature on functional electrical stimulation on hand motor recovery in stroke patients. We discuss the impact of different parameters such as stage after stoke, degree of impairment, spasticity and treatment protocols on the functional outcome. Importantly, we outline the results from recent studies investigating the cortical effects elicited by functional electrical stimulation giving insights into the underlying mechanisms responsible for long-term treatment effects. Bringing together the findings from present research it becomes clear that both, treatment outcomes as well as the neurophysiologic mechanisms causing functional recovery, vary depending on patient characteristics. In order to develop unified treatment guidelines it is essential to conduct homogenous studies assessing the impact of different parameters on rehabilitative success.
Highlights
Neuromuscular electrical stimulation in patients with motor function impairment of the upper extremity has been employed as one rehabilitative treatment option for many years [1]
This review provides an overview of the rehabilitative effect of functional electrical stimulation on hand and finger function in stroke patients
A randomized controlled study by Malhotra et al investigated the effects of neuromuscular electrical stimulation in acute stroke patients with no functional arm movements and found that treatment prevented the development of pain in patients and resulted in improvement of muscle strength [14,66]
Summary
Neuromuscular electrical stimulation in patients with motor function impairment of the upper extremity has been employed as one rehabilitative treatment option for many years [1]. Reviewing the studies assessing cortical effects upon FES, one can observe a trend towards severe impairment leading to activation of the contralesional site, whereas less impaired patients tend to recruit the ipsilesional site (Table 1). This is in line with the current literature of cortical reorganization during stroke recovery, describing the relationship of lateralization and functional outcome [36,37,38]. EMG-mediated FES The onset of stimulation can be triggered either cyclic, by button press or through movement-related EMG
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