Electromyogram-Triggered Neuromuscular Stimulation for Improving the Arm Function of Acute stroke Survivors: A Randomized Pilot Study

Gerard Francisco, MD, Jon Chae, MD, ME, Harmeen Chawla, MD, Steven Kirshblum, MD, Richard Zorowitz, MD, Gerald Lewis, MS, PT, Shcone Pang, MS, OTR. Arch. Phys. Med.

Published in Rehabil 1998; 79:570-575

Summary:

Objective: To assess the efficacy of electromyogram (EMG)-triggered neuromuscular stimulation (EMG-stim) in enhancing upper extremity motor and functional recovery of acute stroke survivors.

Design: A pilot randomized, single-blinded clinical trial.

Setting: Freestanding inpatient rehabilitation facility.

Patients: Nine subjects who were within 6 weeks of their first unifocal. nonhemorrhagic stroke were randomly assigned to either the EMG-stim (n=4) or control (n=5) group. All subjects had a detectable EMG signal (>5?V) from the surface of the paretic extensor carpi radialis and voluntary wrist of the paretic extensor carpi radialis and voluntary wrist extension in synergy or in isolation with muscle grade of <3/5.

Intervention: All subjects received two 30-minute sessions per say of wrist strengthening exercises with EMG-stim (experimental) or without (control) for the duration of their rehabilitation stay.

Main Outcome Measures: Upper extremity Fugl-Meyer motor assessment and the feeding, grooming, and upper body dressing items of the Functional Independence Measure (FIM) were assessed at study entry and at discharge.

Results: Subjects treated with EMG-stim exhibited significantly greater gains in Fugl-Meyer (27.0 vs 10.4; p=.05), and FIM (6.0 vs 3.4: p=.02) scores compared with controls.

Conclusion: Data suggest that EMG-stim enhances the arm function of acute stroke survivors

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