Study on Therapeutic Effects of Electrical Stimulation on Upper Limb Spasticity Following Stroke

Upper motor lesions may produce muscle spasticity which increases the resistance against normal movements. This study aimed at evaluating the therapeutic efficacy of electrical stimulation (ES) on upper limb spasticity following stroke.

In a randomized clinical trial, 75 patients with post-stroke upper limb spasticity were studied during a 19-month period in Tabriz Imam Khomeini Hospital. These patients were randomized in three 25-patient groups; group E received motor level ES on extensor muscles of affected forearm; group F received sensory level ES on flexor muscles of the affected forearm; and group C or control who received sham ES on the affected forearm. ES was applied for 15 days, 0.5 h daily in the interventional groups. Stretching was also employed for all the patients. The grip index, hand index, passive and active range of motion (ROM) and Ashworth scale was determined and compared between the three groups at baseline, after halting the interventions and 6 weeks afterwards.

Spasticity improvement was significantly more prominent in group F compared to the control group 6 weeks post-intervention. Improvement of upper limb function was better in groups E and F compared to the control group. The gripping force was significantly increased after intervention and 6 weeks afterward in group E and to lesser degree in group F. The active ROM was significantly enhanced in some directions (flexion and extension) 6 weeks after cessation of intervention in group E compared to the control group.

ES on flexor and extensor levels in the upper limb along with stretching techniques may improve the spasticity and hand function after stroke.