Volume : 6, Issue : 5, May - 2017

Neuromuscular electrical stimulation for early recovery of motor control of ankle along with spasticity in stroke patients: A prospective randomized controlled study

Annada Sankar Mohes, Kausik Chatterjee, Keya Pradhan, Siddhartha Sankar Dash, L Nilachandra Singh, Akoijam Joy Singh

Abstract :

<p>&nbsp;<b style="text-align: justify;"><span lang="EN-IN" style="font-size:12.0pt;&#10;line-height:200%;font-family:&quot;Times New Roman&quot;,serif;mso-bidi-font-style:italic">Background and objectives</span></b><b style="text-align: justify;"><span lang="EN-IN" style="font-size:12.0pt;line-height:200%;font-family:&quot;Times New Roman&quot;,serif">:</span></b><b style="text-align: justify;"><i><span lang="EN-IN" style="font-size:12.0pt;line-height:200%;font-family:Times-Roman;&#10;mso-fareast-font-family:Calii;mso-fareast-theme-font:minor-latin;mso-bidi-font-family:&#10;Times-Roman"> </span></i></b><span lang="EN-IN" style="text-align: justify; font-size: 12pt; line-height: 200%; font-family: &quot;Times New Roman&quot;, serif;">Effect of neuromuscular electrical stimulation in acute stroke patients while stimulating only single muscle is not known. The purpose of the study is to find the influence of early neuromuscular electrical stimulation to the motor point of tibialis anterior muscle of the affected limb in achieving early motor control of the ankle with reduction in spasticity in post stroke patients.</span><span lang="EN-IN" style="text-align: justify; font-size: 16pt; line-height: 200%; font-family: &quot;Times New Roman&quot;, serif;">&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;</span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;text-align:&#10;justify;line-height:200%"><b><span lang="EN-IN" style="font-size:12.0pt;&#10;line-height:200%;font-family:&quot;Times New Roman&quot;,serif;mso-bidi-font-style:italic">Methods:</span></b><b><i><span lang="EN-IN" style="font-size:12.0pt;line-height:200%;font-family:&quot;Times-BoldItalic&quot;,serif;&#10;mso-bidi-font-family:Times-BoldItalic"> </span></i></b><span lang="EN-IN" style="font-size:12.0pt;line-height:200%;font-family:&quot;Times New Roman&quot;,serif;&#10;mso-bidi-font-weight:bold;mso-bidi-font-style:italic">One hundred and thirty-two subjects were selected between 45-65 years of age and within 2 weeks of the first attack of stroke. They were randomly divided into study and control groups comprising 66 subjects in each group. Study group received</span><span lang="EN-IN" style="font-size:12.0pt;line-height:200%;font-family:&quot;Times New Roman&quot;,serif"> neuromuscular electrical stimulation to tibialis anterior muscle of the affected limb, 15 minutes twice daily, 5 days a week up to 3 weeks along with conventional exercise therapy&nbsp; whereas control group received only exercise therapy for that period. Outcome measures include Modified Ashworth Scale for spasticity of ankle plantarflexors, motor power of ankle dorsiflexors and plantarflexors, motor control of ankle joint. They were recorded before starting treatment, after 3 weeks and at 7 weeks following starting the treatment.<o:p></o:p></span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;text-align:&#10;justify;line-height:200%"><b><span lang="EN-IN" style="font-size:12.0pt;&#10;line-height:200%;font-family:&quot;Times New Roman&quot;,serif;mso-bidi-font-style:italic">Results:<i> </i></span></b><span lang="EN-IN" style="font-size:12.0pt;line-height:200%;&#10;font-family:&quot;Times New Roman&quot;,serif;mso-bidi-font-weight:bold;mso-bidi-font-style:&#10;italic">Significant improvement of spasticity was noticed after 7 weeks follow up (p&lt;0.01). Significant improvement also noticed in ankle dorsiflexor motor power (p&lt;0.001), ankle motor control (p&lt;0.01). <o:p></o:p></span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;text-align:&#10;justify;line-height:200%"><b><span lang="EN-IN" style="font-size:12.0pt;&#10;line-height:200%;font-family:&quot;Times New Roman&quot;,serif;mso-bidi-font-style:italic">Conclusions:</span></b><b><i><span lang="EN-IN" style="font-size:12.0pt;line-height:200%;font-family:&quot;Times-BoldItalic&quot;,serif;&#10;mso-bidi-font-family:Times-BoldItalic"> </span></i></b><span lang="EN-IN" style="font-size:12.0pt;line-height:200%;font-family:&quot;Times New Roman&quot;,serif">Neuromuscular electrical stimulation along with traditional exercise programme is superior to exercise alone for early recovery of ankle motor control, plantarflexor spasticity and ankle dorsiflexor motor strength.<o:p></o:p></span></p>