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Functional electrical stimulation therapy for severe hemiplegia: randomized control trial revisited [with consumer summary]
Marquez-Chin C, Bagher S, Zivanovic V, Popovic MR
Canadian Journal of Occupational Therapy 2017 Apr;84(2):87-97
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

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 number NCT00221078) was carried out involving 21 participants with severe upper-limb hemiplegia (ie, 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.

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