Dosage of neuromuscular electrical stimulation: Is it a determinant of upper limb functional improvement in stroke patients?
Shu-Shyuan Hsu, Ming-Hsia Hu, Jer-Junn Luh, Yen-Ho Wang, Ping-Keung Yip, Ching-Lin Hsieh
Objective: To investigate the predictors related to upper extremity functional recovery, with special emphasis on neuromuscular electrical stimulation dose-response in patients after stroke.
Subjects: Ninety-five patients with stroke who received a 4-week neuromuscular electrical stimulation intervention.
Design: Prospective predictive analysis.
Methods: The change score of the Action Research Arm Test (ARAT) was used as the main outcome. Baseline subject characteristics, stroke-related data, and intervention-related data were collected. Multiple linear regression analysis was applied to identify the potential predictors related to main outcome.
Results: The regression model revealed that the initial Fugl-Meyer upper limb score was the most important predictor for ARAT change score post-test, followed by time since stroke onset and location of stroke lesion. At 2-month follow-up, the neuromuscular electrical stimulation dosage became a significant determinant in addition to the above predictors.
Conclusion: Initial motor severity and lesion location were the main predictors for upper limb functional improvement in stroke patients. Neuromuscular electrical stimulation dosage became a significant determinant for upper limb functional recovery after stroke at 2-month follow-up. More intensive neuromuscular electrical stimulation therapy during early rehabilitation is associated with better upper limb motor function recovery after stroke.