title: Upper-Limb Recovery After Stroke: A Randomized Controlled Trial Comparing EMG-Triggered, Cyclic, and Sensory Electrical Stimulation.
abstract: This study compared the effect of cyclic neuromuscular electrical stimulation (NMES), electromyographically (EMG)-triggered NMES, and sensory stimulation on motor impairment and activity limitations in patients with upper-limb hemiplegia.
  
  
  
  This was a multicenter, single-blind, multiarm parallel-group study of nonhospitalized hemiplegic stroke survivors within 6 months of stroke. A total of 122 individuals were randomized to receive either cyclic NMES, EMG-triggered NMES, or sensory stimulation twice every weekday in 40-minute sessions, over an 8 week-period. Patients were followed for 6 months after treatment concluded.
  
  
  
  There were significant increases in the Fugl-Meyer Assessment [F(1, 111) = 92.6, P < .001], FMA Wrist and Hand [F(1, 111) = 66.7, P < .001], and modified Arm Motor Ability Test [mAMAT; time effect: F(1, 111) = 91.0, P < .001] for all 3 groups. There was no significant difference in the improvement among groups in the FMA [F(2, 384) = 0.2, P = .83], FMA Wrist and Hand [F(2, 384) = 0.4, P = .70], or the mAMAT [F(2, 379) = 1.2, P = .31].
  
  
  
  All groups exhibited significant improvement of impairment and functional limitation with electrical stimulation therapy applied within 6 months of stroke. Improvements were likely a result of spontaneous recovery. There was no difference based on the type of electrical stimulation that was administered.
authors.affiliation: MetroHealth Rehabilitation Institute, MetroHealth Medical Center, Cleveland, OH, USA Case Western Reserve University, Cleveland, OH, USA Cleveland FES Center, Cleveland, OH, USA rwilson@metrohealth.org.
authors.forename: Richard D
authors.initials: RD
authors.lastname: Wilson
authors.affiliation: The Ohio State University, Columbus, OH, USA.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Page
authors.affiliation: Akron General Medical Center, Akron, OH, USA Northeast Ohio Medical University, Rootstown, OH, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Delahanty
authors.affiliation: MetroHealth Rehabilitation Institute, MetroHealth Medical Center, Cleveland, OH, USA Case Western Reserve University, Cleveland, OH, USA Cleveland FES Center, Cleveland, OH, USA.
authors.forename: Jayme S
authors.initials: JS
authors.lastname: Knutson
authors.affiliation: Case Western Reserve University, Cleveland, OH, USA.
authors.forename: Douglas D
authors.initials: DD
authors.lastname: Gunzler
authors.affiliation: MetroHealth Rehabilitation Institute, MetroHealth Medical Center, Cleveland, OH, USA Case Western Reserve University, Cleveland, OH, USA Cleveland FES Center, Cleveland, OH, USA.
authors.forename: Lynne R
authors.initials: LR
authors.lastname: Sheffler
authors.affiliation: MetroHealth Rehabilitation Institute, MetroHealth Medical Center, Cleveland, OH, USA Case Western Reserve University, Cleveland, OH, USA Cleveland FES Center, Cleveland, OH, USA.
authors.forename: John
authors.initials: J
authors.lastname: Chae
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004599:Electric Stimulation Therapy / Q000379:methods*; D004576:Electromyography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D020127:Recovery of Function / Q000502:physiology*; D012720:Severity of Illness Index; D016037:Single-Blind Method; D020521:Stroke / Q000503:physiopathology* / Q000628:therapy*; D016896:Treatment Outcome; D034941:Upper Extremity / Q000503:physiopathology*; D055815:Young Adult
keywords: electrical stimulation; function; recovery; stroke