title: Transcutaneous electrical stimulation on acupoints combined with task-related training to improve motor function and walking performance in an individual 7 years poststroke: a case study.
abstract: OBJECTIVE
  Impaired walking function and spasticity are common sequelae of stroke. Prior studies have shown that a rehabilitation program combining transcutaneous electrical stimulation (TES) with task-related training (TRT) improves motor function in individuals with stroke. However, it is unclear if this approach is beneficial for individuals with long-standing stroke.
  
  
  METHODS
  The subject of this case study was a 61-year-old man who was 7 years poststroke. He exhibited limitations of walking function, impaired strength of the ankle muscles, and severe plantarflexor spasticity.
  
  
  METHODS
  For 4 weeks, the patient performed a 5-day/wk home program consisting of 60 minutes of TES (below motor threshold) to the acupoints in the affected lower leg, followed by 60 minutes of TRT. He documented his daily home program activities in a log, and 3 times a week he received a call from the therapist to verify his adherence. The patient also had 8 clinic visits, which focused on instruction to ensure adherence to the (TES + TRT) protocol and progression of the program.
  
  
  RESULTS
  After the 4-week program, plantarflexor spasticity decreased and ankle dorsi- and plantarflexor strength improved. More important, there were notable improvements in gait velocity, walking endurance, and functional mobility. These gains were maintained at 4 weeks posttreatment.
  
  
  CONCLUSIONS
  This accessible home program was safe and effective for decreasing impairment and improving function in an individual with long-term, chronic stroke. The gains were maintained 4 weeks posttreatment. Details are provided for developing a home program integrating somatosensory TES and TRT.
authors.affiliation: The Hong Kong Polytechnic University, Hong Kong.
authors.forename: Shamay S M
authors.initials: SS
authors.lastname: Ng
authors.forename: Christina W Y
authors.initials: CW
authors.lastname: Hui-Chan
mesh_terms: D015669:Acupuncture Points; D000842:Ankle; D002908:Chronic Disease; D005081:Exercise Therapy; D005684:Gait; D017408:Guidelines as Topic; D006429:Hemiplegia / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation; D006699:Home Care Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009068:Movement; D009128:Muscle Spasticity / Q000209:etiology / Q000503:physiopathology; D053580:Muscle Strength; D010807:Physical Endurance; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications / Q000503:physiopathology*; D000071939:Stroke Rehabilitation; D013997:Time Factors; D004561:Transcutaneous Electric Nerve Stimulation / Q000379:methods*; D016896:Treatment Outcome; D016138:Walking