title: Cortical effect and functional recovery by the electromyography-triggered neuromuscular stimulation in chronic stroke patients.
abstract: We investigated the effect of electromyography (EMG)-triggered neuromuscular electrical stimulation (NMES; EMG-stim) on functional recovery of the hemiparetic hand and the related cortical activation pattern in chronic stroke patients. We enrolled 14 stroke patients, who were randomly assigned to the EMG-stim (n=7) or the control groups (n=7). The EMG-stim was applied to the wrist extensor of the EMG-stim group for two sessions (30 min/session) a day, five times per week for 10 weeks. Four functional tests (box and block, strength, the accuracy index, and the on/offset time of muscle contraction) and functional MRI (fMRI) were performed before and after treatment. fMRI was measured at 1.5 T in parallel with timed finger flexion-extension movements at a fixed rate. Following treatment, the EMG-stim group showed a significant improvement in all functional tests. The main cortical activation change with such functional improvement was shifted from the ipsilateral sensorimotor cortex (SMC) to the contralateral SMC. We demonstrated that 10-week EMG-stim can induce functional recovery and change of cortical activation pattern in the hemiparetic hand of chronic stroke patients.
authors.affiliation: Department of Physical Therapy, College of Health Science, Catholic University of Daegu, Republic of Korea.
authors.forename: Hwa Kyung
authors.initials: HK
authors.lastname: Shin
authors.forename: Sang Hyun
authors.initials: SH
authors.lastname: Cho
authors.forename: Hye-seon
authors.initials: HS
authors.lastname: Jeon
authors.forename: Young-Hee
authors.initials: YH
authors.lastname: Lee
authors.forename: Jun Chan
authors.initials: JC
authors.lastname: Song
authors.forename: Sung Ho
authors.initials: SH
authors.lastname: Jang
authors.forename: Chu-Hee
authors.initials: CH
authors.lastname: Lee
authors.forename: Yong Hyun
authors.initials: YH
authors.lastname: Kwon
mesh_terms: D001921:Brain / Q000503:physiopathology*; D004599:Electric Stimulation Therapy; D004576:Electromyography; D005260:Female; D007839:Functional Laterality; D006225:Hand / Q000502:physiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function / Q000502:physiology*; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation