title: Effects of neuromuscular electrical stimulation on arterial hemodynamic properties and body composition in paretic upper extremities of patients with subacute stroke.
abstract: BACKGROUND
  Neuromuscular electric stimulation (NMES) induces repeated muscular contraction, possibly promoting the perfusion/oxygenation of the regional tissues. It remains unclear how NMES influences vascular hemodynamic property and segmental fluid distribution/composition in paretic extremities of hemiplegic patients.
  
  
  METHODS
  Eleven hemiplegic patients aged 62.6 ± 12.5 years in the subacute stage of stroke received NMES for paretic wrist extensor and flexor muscles 30 min daily, 5 days per week for 4 weeks. The non-paretic upper extremities (NPUE) that did not receive NMES served as control. Distribution of fluid to intra/extracellular milieu and arterial hemodynamic properties were determined by using the multi-frequency bioelectrical impedance and pulse wave analysis, respectively.
  
  
  RESULTS
  Compared with NPUE without NMES, paretic upper extremity (PUE) with NMES revealed a significantly less decrease in arterial blood flow, impedance quotient, slope quotient, and less increase in crest width and crest time of arterial pulse wave. NMES for 4 weeks increased body cell mass in PUE. Furthermore, NPUE without NMES reduced intracellular water, whereas PUE with NMES retarded loss of intracellular water after stroke.
  
  
  CONCLUSIONS
  NMES therapy increases body cell mass, attenuates reduction of intracellular water, and alleviates arterial hemodynamic disturbance in PUE in subacute stroke. However, stroke-related physical deconditioning may negatively regulate body composition and impair hemodynamic function in NPUE.
authors.forename: Shu-Chun
authors.initials: SC
authors.lastname: Huang
authors.forename: Alice May-Kuen
authors.initials: AM
authors.lastname: Wong
authors.forename: Yu-Fen
authors.initials: YF
authors.lastname: Chuang
authors.forename: Yu-Chuan
authors.initials: YC
authors.lastname: Liu
authors.forename: Wei-Lun
authors.initials: WL
authors.lastname: Tsai
authors.affiliation: Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Jong-Shyan
authors.initials: JS
authors.lastname: Wang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001158:Arteries / Q000601:surgery; D001823:Body Composition / Q000502:physiology*; D004599:Electric Stimulation Therapy; D004576:Electromyography / Q000379:methods; D005260:Female; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009119:Muscle Contraction / Q000502:physiology; D020521:Stroke / Q000628:therapy*; D034941:Upper Extremity