This post on the benefits of functional electrical stimulation on stroke patients is brought to you by Spring 2021 Intern, Kevan. Kevan was a dedicated intern this semester and CORE appreciates him sharing what he learned about why we incorporate functional electrical stimulation for our stroke clients into their activity-based training programs. Not only is functional electrical stimulation backed by scientific research, but we have personally seen recovery outcomes improved in our stroke clients who consistently use it.
Benefits of Functional Electrical Stimulation on Stroke Patients
A stroke is a medical emergency that occurs when the blood supply to the brain becomes interrupted or reduced, which prevents brain tissue from getting nutrients and oxygen, leading to brain cells dying within minutes. It is the leading cause of disability in America and the 5th leading cause of death, as well. One common side effect of a stroke is hemiplegia, which is the impairment of moving one side of the body. This can be from very mild to severe and motor function can go from almost noticeable to completely gone. However, electrical stimulation can help to evoke a response in excitable cells and neurons, which can help to produce a functional movement. Functional electrical stimulation (FES) is a type of neuromuscular stimulation that is used in rehab and movement as it assists with powerful and functional movements.1
In a 2007 pilot study done by Alon et al., they examined the effectiveness of FES on upper extremity recovery during stroke rehab and found promising results on small groups of 15 after completing 12 weeks of rehab. They found that when comparing the FES group, who performed PT and OT with the FES, to the control group who just did the PT and OT, there was a 20% greater recovery of upper extremity function and motor control when training with FES versus training without it. 2 To test their hypothesis of whether or not FES helps with upper extremity recovery during stroke rehab, they had all patients complete the Action Research Arm Test (ARAT), which tested the grip, grasp, pinch, and gross movements of hand function. At the end of the study, they concluded that even patients who didn’t exhibit any functional movement at the start, were able to transfer blocks after the 12 weeks. They also came to the conclusion that FES when paired with task related exercises resulted in better functional recovery of the upper extremity, rather than completing tasks without FES.
Just as FES can help with upper extremity recovery, it can also benefit the lower extremity via active cycling. In a 2016 study done by Peri et al. a group of eldery stroke patients were placed in either a control or experimental group where they did 75 minutes of training for 15 days within 3 weeks. It involved FES augmented active cycling where they would do 25 minutes of FES cycling and 50 minutes of regular physiotherapy. During the cycling, stim was placed on the quadriceps, hamstrings, tibialis anterior, and gastrocnemius lateralis muscles of both legs. Despite the groups being very small in size, they were able to find that the experimental group not only had an increased gait speed, but were the only group that maintained a median improvement higher than the minimal clinical difference (0.16 m/s). The double support time was also reduced significantly which resulted in a less impaired gait gesture. 3 Although a much higher group size would be beneficial and lead to a more conclusive result, this small FES cycle experiment shows a bright promise for stroke patients.
Overall, Functional Electrical Stimulation can be a very beneficial tool that can be added to any restorative therapy and task related program to help restore functional movement in the muscles affected by stroke. Call CORE at 407-951-8936 for more information on how you can incorporate FES into your recovery.