Does the use of TENS increase the effectiveness of exercise for improving walking after stroke? A randomized controlled clinical trial.
OBJECTIVE
To investigate whether surface electrical stimulation can increase the effectiveness of task-related exercises for improving the walking capacity of patients with chronic stroke.


METHODS
Randomized, placebo-controlled clinical trial.


METHODS
Home-based programme.


METHODS
One hundred and nine hemiparetic stroke survivors were assigned randomly to: (1) transcutaneous electrical nerve stimulation (TENS), (2) TENS + exercise, (3) placebo stimulation + exercise, or (4) control group.


METHODS
The TENS group received 60 minutes of electrical stimulation. Both the TENS + exercise group and placebo stimulation + exercise group did 60 minutes of exercises, followed respectively by 60 minutes of electrical and placebo stimulation. Treatment was given five days a week for four weeks. The control group had no active treatment.


METHODS
Comfortable gait speed was measured using a GAITRite II walkway system. Walking endurance and functional mobility were measured by the distance covered during a 6-minute walk test (6MWT) and by timed up and go test scores before treatment, after two weeks and after four weeks of treatment, and at follow-up four weeks after treatment ended.


RESULTS
When compared with the other three groups, only the combined TENS + exercise group showed significantly greater absolute and percentage increases in gait velocity (by 37.1-57.5%, all P<0.01) and reduction in timed up and go scores (by -14.9 to -23.3%, P<0.01) from week 2 onwards. When compared with the control and TENS groups, only the combined TENS + exercise group covered significantly more distance in the 6MWT (by 22.2-34.7%, P<0.01) from week 2 onwards.


CONCLUSIONS
TENS can improve the effectiveness of task-related exercise for increasing walking capacity in hemiparetic stroke survivors.
Ng
Shamay S M
SS
Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong.
Hui-Chan
Christina W Y
CW
D000368:Aged; D005081:Exercise Therapy; D017079:Exercise Tolerance; D005260:Female; D006429:Hemiplegia / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009128:Muscle Spasticity / Q000534:rehabilitation; D018482:Muscle, Skeletal / Q000503:physiopathology; D020127:Recovery of Function; D020521:Stroke / Q000150:complications / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D004561:Transcutaneous Electric Nerve Stimulation; D016138:Walking