Functional electrical stimulation therapy for severe hemiplegia: Randomized control trial revisited.

BACKGROUND: Stroke is the leading cause of long-term disability. Stroke survivors seldom improve their upper-limb function when their deficit is severe, despite recently developed therapies.

PURPOSE: This study aims to assess the efficacy of functional electrical stimulation therapy in improving voluntary reaching and grasping after severe hemiplegia.

METHOD: A post hoc analysis of a previously completed randomized control trial ( clinicaltrials.gov , No. NCT00221078) was carried out involving 21 participants with severe upper-limb hemiplegia (i.e., Fugl-Meyer Assessment-Upper Extremity [FMA-UE] ≤ 15) resulting from stroke.

FINDINGS: Functional Independence Measure Self-Care subscores increased 22.8 (±6.7) points in the intervention group and 9 (±6.5) in the control group, following 40 hr of equal-intensity therapy. FMA-UE score changes were 27.2 (±13.5) and 5.3 (±11.0) for the intervention and control groups, respectively.

IMPLICATIONS: The results may represent the largest upper-limb function improvements in any stroke population to date, especially in those with severe upper-limb deficit.