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    Combined arm stretch positioning and neuromuscular electrical stimulation during rehabilitation does not improve range of motion, shoulder pain or function in patients after stroke: A randomised trial

    Access Status
    Open access via publisher
    Authors
    De Jong, Lex
    Dijkstra, P.
    Gerritsen, J.
    Geurts, A.
    Postema, K.
    Date
    2013
    Type
    Journal Article
    
    Metadata
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    Citation
    De Jong, L. and Dijkstra, P. and Gerritsen, J. and Geurts, A. and Postema, K. 2013. Combined arm stretch positioning and neuromuscular electrical stimulation during rehabilitation does not improve range of motion, shoulder pain or function in patients after stroke: A randomised trial. Journal of Physiotherapy. 59 (4): pp. 245-254.
    Source Title
    Journal of Physiotherapy
    DOI
    10.1016/S1836-9553(13)70201-7
    ISSN
    1836-9553
    School
    School of Physiotherapy and Exercise Science
    URI
    http://hdl.handle.net/20.500.11937/57842
    Collection
    • Curtin Research Publications
    Abstract

    Question: Does static stretch positioning combined with simultaneous neuromuscular electrical stimulation (NMES) in the subacute phase after stroke have beneficial effects on basic arm body functions and activities? Design: Multicentre randomised trial with concealed allocation, assessor blinding, and intention-to-treat analysis. Participants: Forty-six people in the subacute phase after stroke with severe arm motor deficits (initial Fugl-Meyer Assessment arm score = 18). Intervention: In addition to conventional stroke rehabilitation, participants in the experimental group received arm stretch positioning combined with motor amplitude NMES for two 45-minute sessions a day, five days a week, for eight weeks. Control participants received sham arm positioning (ie, no stretch) and sham NMES (ie, transcutaneous electrical nerve stimulation with no motor effect) to the forearm only, at a similar frequency and duration. Outcome measures: The primary outcome measures were passive range of arm motion and the presence of pain in the hemiplegic shoulder. Secondary outcome measures were severity of shoulder pain, restrictions in performance of activities of daily living, hypertonia, spasticity, motor control and shoulder subluxation. Outcomes were assessed at baseline, mid-treatment, at the end of the treatment period (8 weeks) and at follow-up (20 weeks). Results: Multilevel regression analysis showed no sig nificant group effects nor significant time × group interactions on any of the passive range of arm motions. The relative risk of shoulder pain in the experimental group was non-significant at 1.44 (95% CI 0.80 to 2.62). Conclusion: In people with poor arm motor control in the subacute phase after stroke, static stretch positioning combined with simultaneous NMES has no statistically significant effects on range of motion, shoulder pain, basic arm function, or activities of daily living. © 2013 Australian Physiotherapy Association.

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