Functional electrical stimulation therapy for severe hemiplegia: Randomized control trial revisited

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, No. NCT00221078) was carried out involving 21 participants with severe upper-limb hemiplegia (i.e., 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.