The effects of electromyographic-triggered neuromuscular electrical muscle stimulation on the functional hand recovery among stroke survivors.

Abstract

Restoration of functional hand following stroke still presents formidable challenges to physiotherapists. The study evaluated the effectiveness of EMG-triggered NMES on the functional hand recovery of stroke survivors. Nineteen stroke survivors referred for physiotherapy at Korle-Bu Teaching Hospital, Accra Ghana, were consecutively assigned into an Intervention (IV) and the usual care (UC) groups. The outcome measures included box and block timed manipulation test, action research arm test (ARAT) and an adapted hand dynamometry. Measurements were recorded at baseline, at 4 and 8 weeks of the treatment by an independent assessor. The intervention group received EMG-triggered NMES in addition to the usual care during the evaluation period. Statistical analysis involved Freidman Two way ANOVA by ranks to evaluate the statistical significant changes within each group whilst Mann-Whitney U test compared the differences in the post treatment variables between the two groups. Alpha level was set at P < 0.05. The mean periods of onset of stroke were 3.63 +/- 2.13 and 5.50 +/- 2.16 months for UC and IV groups respectively. There was no significant difference (P > 0.05) in the periods of onset of stroke and ages between the two groups. Within group comparison showed significant performance (P < 0.05) on the outcome measures post baseline. No significant difference occurred between both groups except in ARAT where intervention group performed significantly better (P < 0.05) at the 8th week of the evaluation. It was concluded that inclusion of EMG-triggered NMES could contribute to a better functional hand recovery among stroke survivors during recovery stage.