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Targeted electrical stimulation may boost hand and arm function



Electrical stimulation improves motor, sensory and cognitive recovery of hand and arm function after stroke, according to a new study.

The research, published in Cell, was conducted by a consortium of neuroscientists, clinicians and neuroengineers.

A total of 45 chronic stroke patients underwent 27 sessions of Neuromuscular Electrical Stimulation (NMES) over a period of nine weeks.

Each session lasted 90 minutes, 60 of which consisted of conventional rehab while the final 30 minutes involved treatment based on a robotic glove or custom NMES.

One group used a robotic glove to perform the task-driven exercises, the second group used NMES and the third used the glove in half the sessions and NMES in the others.

The scientists then measured motor performances, sensory capabilities and body perception for each patient, before, during and after the nine-week clinical trial.

Patient performance improved sooner with NMES than the robotic glove and at the end of the treatment, motor improvement was higher in the NMES and mixed group than those who only used the glove.

Improvement extended to somatosensory function and body representation measures.

First author Andrea Crema of the EPFL Translational Neural Engineering laboratory said:

“Our approach has the potential to facilitate neurorehabilitative interventions that target multiple perceptual domains, including tactile acuity, perceived body size, distorted feelings of the arm, and consequently, restored use of the arm.

“Our approach reduced the perceptual dissociation of the affected limb, that’s why it’s so important to pursue targeted electrical stimulation of the muscles in chronic stroke survivors, and to personalise the treatment to counter specific deficits.”

The study focused on chronic stroke patients whose recovery had plateaued after having undergone multiple interventions.

However, the findings suggest that patients who have just suffered a stroke may also benefit from NMES treatment.

Crema said:

“The challenge with sub-acute stroke patients relies in the more volatile sensory perception and body representation.

“They may have higher benefits from NMES if properly personalised to their quickly changing conditions.”