title: The effects of transcutaneous electrical nerve stimulation on strength, proprioception, balance and mobility in people with stroke: a randomized controlled cross-over trial.
abstract: OBJECTIVE
  To investigate the feasibility and potential efficacy of 'activeTENS' (that is transcutaneous electrical nerve stimulation (TENS) during everyday activities) by assessing the immediate effects on strength, proprioception, balance/falls risk and mobility after stroke.
  
  
  METHODS
  A paired-sample randomized cross-over trial.
  
  
  METHODS
  Twenty-nine mobile chronic stroke survivors with no pre-existing conditions limiting balance or mobility or contra-indications to TENS.
  
  
  METHODS
  University clinical research facility.
  
  
  METHODS
  A single session of 'activeTENS' delivered via a 'sock electrode' (70-130 Hz, five second cycle) plus a session of control treatment (wearing the sock electrode with no stimulation), lasting approximately two hours in total.
  
  
  RESULTS
  Dorsiflexor and plantarflexor strength and proprioception using an isokinetic dyanometer, balance and falls risk (Standing Forward Reach Test) and gait speed (10-m walk test).
  
  
  RESULTS
  All participants tolerated 'active TENS'. Most parameters improved during stimulation with activeTENS; balance (p = 0.009), gait speed (p = 0.002), plantarflexor strength (p = 0.008) and proprioception of plantarflexion (p = 0.029), except dorsiflexor strength (p = 0.194) and dorsiflexion proprioception (p = 0.078).
  
  
  CONCLUSIONS
  The results provide initial evidence of the potential of 'active TENS' to benefit physical function after stroke which warrants further phase II trials to develop the intervention. Concerns that stimulation could have a detrimental impact on balance and increase risk of falls were not supported.
authors.affiliation: Stroke and Vascular Research Centre, University of Manchester, Manchester, UK. sarah.tyson@manchester.ac.uk
authors.forename: Sarah F
authors.initials: SF
authors.lastname: Tyson
authors.forename: Ebrahim
authors.initials: E
authors.lastname: Sadeghi-Demneh
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Nester
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018592:Cross-Over Studies; D004599:Electric Stimulation Therapy; D005260:Female; D020233:Gait Disorders, Neurologic / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D053580:Muscle Strength / Q000502:physiology*; D004856:Postural Balance / Q000502:physiology*; D011434:Proprioception / Q000502:physiology*; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation
keywords: Balance; TENS (transcutaneous electrical nerve stimulation); mobility; proprioception; stroke