Functional electrical stimulation on chronic and acute hemiplegic shoulder subluxation

Objective: The present study investigated and assessed the effectiveness of a functional electrical stimulation (FES) program in the management of acute and chronic shoulder subluxation. Design: By their postonset duration, hemiplegic subjects with subluxation participating in the study were placed into a short-duration group and a long-duration group. Subjects in each group were further assigned randomly to either a control subgroup or an experimental subgroup. The experimental subgroups of both short and long duration received FES therapy in which supraspinatus and posterior deltoid were induced to contract repetitively up to 6 hr/day for 6 wk. The duration of the FES session and muscle contraction/relaxation ratio were progressively increased as performance improved. Results: The experimental subgroup of short duration showed significant improvements in reducing subluxation as indicated by x-ray compared with the control subgroup of short duration after the first FES treatment. The same effect was not shown for the experimental subgroup of long duration. The second FES treatment program only resulted in an insignificant change of shoulder subluxation for both the short- and long-duration subgroups. Conclusions: The present study suggests that hemiplegic subjects with short postonset duration are effectively trained for shoulder subluxation by the first FES treatment program. The same FES showed not to be effective when applied to the subjects with subluxation of >1 yr.