Electromyogram-triggered neuromuscular stimulation for improving the arm function of acute stroke survivors: A randomized pilot study

Objective: To assess the efficacy of electromyogram (EMG)triggered neuromuscular stimulation (EMG-stim) in enhancing upper extremity motor and functional recovery of acute stroke survivors. Design: A pilot randomized, single-blinded clinical trial. Setting: Freestanding inpatient rehabilitation facility. Patients: Nine subjects who were within 6 weeks of their first unifocal, nonhemorrhagic stroke were randomly assigned to either the EMG-stim (n = 4) or control (n = 5) group. All subjects had a detectable EMG signal (>5 mu V) from the surface of the paretic extensor carpi radialis and voluntary wrist extension in synergy or in isolation with muscle grade of <3/5. Intervention: All subjects received two 30-minute sessions per day of wrist strengthening exercises with EMG-stim (experimental) or without (control) for the duration of their rehabilitation stay. Main Outcome Measures: Upper extremity Fugl-Meyer motor assessment and the feeding, grooming, and upper body dressing items of the Functional Independence Measure (FIM) were assessed at study entry and at discharge. Results: Subjects treated with EMG-stim exhibited significantly greater gains in Fugl-Meyer (27.0 vs 10.4; p = .05), and FIM (6.0 vs 3.4; p = .02) scores compared with controls. Conclusion: Data suggest that EMG-stim enhances the arm function of acute stroke survivors. (C) 1998 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.