The Effects of Transcutaneous Electrical Nerve Stimulation for Standing Balance in Patients with Hemiplegia

Objective: To evaluate the effects of transcutaneous electrical nerve stimulation (TENS) applied at lower extremity for standing balance in patients with hemiplegia. Method: Twenty-two hemiplegic patients were tested while standing on balance trainer under eight stimulation modes (No TENS, bilateral TENS, hemiplegic TENS, and unaffected TENS. These four conditions were applied both with and without vision). All patients were able to stand independently more than five minutes. TENS was applied with pulse width 200 mu s, frequency of 100 Hz, amplitude set at the sensory detection threshold of each patients. TENS was applied thirty seconds for each stimulation modes, and resting period was 10 minutes. Postural sway was determined during the testing period by the sum of anterior-posterior (AP) center of pressure (COP) sway, medio-lateral (ML) COP sway, and total sum of COP sway. Also postural sway was determined by proportion of time of COP in three circles, which semidiameters are 10 mm, 20 mm, 30 mm each. Results: When patients were applied with TENS eyes closed at the unaffected lower extremity, AP, ML, and total sum of COP sway decreased significantly. Conclusion: In hemiplegic patients with independent standing, TENS application at the unaffected leg over five minutes can be helpful standing balance enhancement.