Effects of combining robot-assisted therapy with neuromuscular electrical stimulation on motor impairment, motor and daily function, and quality of life in patients with chronic stroke: A double-blinded randomized controlled trial

Ya Yun Lee, Keh Chung Lin, Hsiao Ju Cheng, Ching Yi Wu*, Yu Wei Hsieh, Chih Kuang Chen

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

44 Scopus citations

Abstract

Background: Robot-assisted therapy (RT) is a widely used intervention approach to enhance motor recovery in patients after stroke, but its effects on functional improvement remained uncertain. Neuromuscular electrical stimulation (NMES) is one potential adjuvant intervention approach to RT that could directly activate the stimulated muscles and improve functional use of the paretic hand. Methods: This was a randomized, double-blind, sham-controlled study. Thirty-nine individuals with chronic stroke were randomly assigned to the RT combined with NMES (RT + ES) or to RT with sham stimulation (RT + Sham) groups. The participants completed the intervention 90 to 100 minutes/day, 5 days/week for 4 weeks. The outcome measures included the upper extremity Fugl-Meyer Assessment (UE-FMA), modified Ashworth scale (MAS), Wolf Motor Function Test (WMFT), Motor Activity Log (MAL), and Stroke Impact Scale 3.0 (SIS). All outcome measures were assessed before and after intervention, and the UE-FMA, MAL, and SIS were reassessed at 3 months of follow-up. Results: Compared with the RT + Sham group, the RT + ES group demonstrated greater improvements in wrist flexor MAS score, WMFT quality of movement, and the hand function domain of the SIS. For other outcome measures, both groups improved significantly after the interventions, but no group differences were found. Conclusion: RT + ES induced significant benefits in reducing wrist flexor spasticity and in hand movement quality in patients with chronic stroke. Trial registration: ClinicalTrials.gov.

Original languageEnglish
Article number96
JournalJournal of NeuroEngineering and Rehabilitation
Volume12
Issue number1
DOIs
StatePublished - 31 10 2015

Bibliographical note

Publisher Copyright:
© 2015 Lee et al.

Keywords

  • Electrical stimulation
  • Rehabilitation
  • Robot-assisted therapy
  • Stroke

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