Transcutaneous electrical nerve stimulation combined with task-related training improves lower limb functions in subjects with chronic stroke
Previous studies have shown that repeated sensory inputs could enhance brain plasticity and cortical motor output. The purpose of this study was to investigate whether combining electrically induced sensory inputs through transcutaneous electrical nerve stimulation (TENS) with task-related training...
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| Veröffentlicht in: | Stroke (1970) 2007-11, Vol.38 (11), p.2953-2959 |
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| creator | NG, Shamay S. M HUI-CHAN, Christina W. Y |
| description | Previous studies have shown that repeated sensory inputs could enhance brain plasticity and cortical motor output. The purpose of this study was to investigate whether combining electrically induced sensory inputs through transcutaneous electrical nerve stimulation (TENS) with task-related training (TRT) in a home-based program would augment voluntary motor output in chronic stroke survivors better than either treatment alone or no treatment.
Eighty-eight patients with stroke were assigned randomly to receive a home-based program of (1) TENS, (2) TENS+TRT, (3) placebo TENS+TRT, or (4) no treatment (control) 5 days a week for 4 weeks. Outcome measurements included Composite Spasticity Scale, peak torques generated during maximum isometric voluntary contraction of ankle dorsiflexors and plantarflexors, and gait velocity recorded at baseline, after 2 and 4 weeks of treatment, and 4 weeks after treatment ended.
When compared with TENS, the combined TENS+TRT group showed significantly greater improvement in ankle dorsiflexion torque at follow-up and in ankle plantarflexion torque at week 2 and follow-up (P |
| doi_str_mv | 10.1161/STROKEAHA.107.490318 |
| format | Article |
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Eighty-eight patients with stroke were assigned randomly to receive a home-based program of (1) TENS, (2) TENS+TRT, (3) placebo TENS+TRT, or (4) no treatment (control) 5 days a week for 4 weeks. Outcome measurements included Composite Spasticity Scale, peak torques generated during maximum isometric voluntary contraction of ankle dorsiflexors and plantarflexors, and gait velocity recorded at baseline, after 2 and 4 weeks of treatment, and 4 weeks after treatment ended.
When compared with TENS, the combined TENS+TRT group showed significantly greater improvement in ankle dorsiflexion torque at follow-up and in ankle plantarflexion torque at week 2 and follow-up (P<0.01). When compared with placebo+TRT, the TENS+TRT group produced earlier and greater reduction of plantarflexor spasticity and improvement in ankle dorsiflexion torque at week 2 (P<0.01). When compared with all 3 groups, the TENS+TRT group showed significantly greater improvement in gait velocity (P<0.01).
In patients with chronic stroke, 20 sessions of a combined TENS+TRT home-based program decreased plantarflexor spasticity, improved dorsiflexor and plantarflexor strength, and increased gait velocity significantly more than TENS alone, placebo+TRT, or no treatment. Such improvements can even be maintained 4 weeks after treatment ended.</description><identifier>ISSN: 0039-2499</identifier><identifier>EISSN: 1524-4628</identifier><identifier>DOI: 10.1161/STROKEAHA.107.490318</identifier><identifier>PMID: 17901383</identifier><identifier>CODEN: SJCCA7</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Activities of Daily Living ; Afferent Pathways - physiology ; Aged ; Analgesics ; Ankle Joint - physiology ; Biological and medical sciences ; Chronic Disease ; Electric Stimulation Therapy - methods ; Exercise Therapy - methods ; Female ; Gait Disorders, Neurologic - etiology ; Gait Disorders, Neurologic - physiopathology ; Gait Disorders, Neurologic - rehabilitation ; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy ; Home Care Services ; Humans ; Lower Extremity - innervation ; Lower Extremity - physiopathology ; Male ; Medical sciences ; Middle Aged ; Movement - physiology ; Muscle Spasticity - etiology ; Muscle Spasticity - physiopathology ; Muscle Spasticity - rehabilitation ; Nervous system (semeiology, syndromes) ; Neurology ; Neuropharmacology ; Paresis - etiology ; Paresis - physiopathology ; Paresis - rehabilitation ; Peripheral Nerves - physiopathology ; Pharmacology. Drug treatments ; Range of Motion, Articular - physiology ; Recovery of Function - physiology ; Reflex, Stretch - physiology ; Single-Blind Method ; Stroke - complications ; Stroke - physiopathology ; Stroke Rehabilitation ; Transcutaneous Electric Nerve Stimulation - methods ; Treatment Outcome ; Vascular diseases and vascular malformations of the nervous system</subject><ispartof>Stroke (1970), 2007-11, Vol.38 (11), p.2953-2959</ispartof><rights>2007 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c449t-7d19dfa3afaad5a8c026d1aabb2a49475b143d3c9d3ca220a19e19c9c07be11c3</citedby><cites>FETCH-LOGICAL-c449t-7d19dfa3afaad5a8c026d1aabb2a49475b143d3c9d3ca220a19e19c9c07be11c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,3674,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=19215746$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17901383$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>NG, Shamay S. M</creatorcontrib><creatorcontrib>HUI-CHAN, Christina W. Y</creatorcontrib><title>Transcutaneous electrical nerve stimulation combined with task-related training improves lower limb functions in subjects with chronic stroke</title><title>Stroke (1970)</title><addtitle>Stroke</addtitle><description>Previous studies have shown that repeated sensory inputs could enhance brain plasticity and cortical motor output. The purpose of this study was to investigate whether combining electrically induced sensory inputs through transcutaneous electrical nerve stimulation (TENS) with task-related training (TRT) in a home-based program would augment voluntary motor output in chronic stroke survivors better than either treatment alone or no treatment.
Eighty-eight patients with stroke were assigned randomly to receive a home-based program of (1) TENS, (2) TENS+TRT, (3) placebo TENS+TRT, or (4) no treatment (control) 5 days a week for 4 weeks. Outcome measurements included Composite Spasticity Scale, peak torques generated during maximum isometric voluntary contraction of ankle dorsiflexors and plantarflexors, and gait velocity recorded at baseline, after 2 and 4 weeks of treatment, and 4 weeks after treatment ended.
When compared with TENS, the combined TENS+TRT group showed significantly greater improvement in ankle dorsiflexion torque at follow-up and in ankle plantarflexion torque at week 2 and follow-up (P<0.01). When compared with placebo+TRT, the TENS+TRT group produced earlier and greater reduction of plantarflexor spasticity and improvement in ankle dorsiflexion torque at week 2 (P<0.01). When compared with all 3 groups, the TENS+TRT group showed significantly greater improvement in gait velocity (P<0.01).
In patients with chronic stroke, 20 sessions of a combined TENS+TRT home-based program decreased plantarflexor spasticity, improved dorsiflexor and plantarflexor strength, and increased gait velocity significantly more than TENS alone, placebo+TRT, or no treatment. Such improvements can even be maintained 4 weeks after treatment ended.</description><subject>Activities of Daily Living</subject><subject>Afferent Pathways - physiology</subject><subject>Aged</subject><subject>Analgesics</subject><subject>Ankle Joint - physiology</subject><subject>Biological and medical sciences</subject><subject>Chronic Disease</subject><subject>Electric Stimulation Therapy - methods</subject><subject>Exercise Therapy - methods</subject><subject>Female</subject><subject>Gait Disorders, Neurologic - etiology</subject><subject>Gait Disorders, Neurologic - physiopathology</subject><subject>Gait Disorders, Neurologic - rehabilitation</subject><subject>Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy</subject><subject>Home Care Services</subject><subject>Humans</subject><subject>Lower Extremity - innervation</subject><subject>Lower Extremity - physiopathology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Movement - physiology</subject><subject>Muscle Spasticity - etiology</subject><subject>Muscle Spasticity - physiopathology</subject><subject>Muscle Spasticity - rehabilitation</subject><subject>Nervous system (semeiology, syndromes)</subject><subject>Neurology</subject><subject>Neuropharmacology</subject><subject>Paresis - etiology</subject><subject>Paresis - physiopathology</subject><subject>Paresis - rehabilitation</subject><subject>Peripheral Nerves - physiopathology</subject><subject>Pharmacology. Drug treatments</subject><subject>Range of Motion, Articular - physiology</subject><subject>Recovery of Function - physiology</subject><subject>Reflex, Stretch - physiology</subject><subject>Single-Blind Method</subject><subject>Stroke - complications</subject><subject>Stroke - physiopathology</subject><subject>Stroke Rehabilitation</subject><subject>Transcutaneous Electric Nerve Stimulation - methods</subject><subject>Treatment Outcome</subject><subject>Vascular diseases and vascular malformations of the nervous system</subject><issn>0039-2499</issn><issn>1524-4628</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkc9u1DAQhy0EokvhDRDyBW7Zemznj4-rqlBEpUp0e44mjkPdJk7xOK14CN4ZV1nRYw-WpfE3v7HmY-wjiC1ABSdX-5-XP85257stiHqrjVDQvGIbKKUudCWb12wjhDKF1MYcsXdEt0IIqZryLTuC2ghQjdqwv_uIgeySMLh5Ie5GZ1P0FkceXHxwnJKflhGTnwO389T54Hr-6NMNT0h3RXT5LVdSRB98-MX9dB_nB0d8nB9d5KOfOj4swT4FEPeB09Ld5hm0htibOAdv85g437n37M2AI7kPh_uYXX8925-eFxeX376f7i4Kq7VJRd2D6QdUOCD2JTZWyKoHxK6TqI2uyw606pU1-aCUAsE4MNZYUXcOwKpj9mXNzX_9vThK7eTJunFct9BWjS7zjuFFUIoSjJEyg3oFbZyJohva--gnjH9aEO2Tr_a_r1yp29VXbvt0yF-6yfXPTQdBGfh8AJCylCHbsp6eOSOhrHWl_gEkaaPL</recordid><startdate>20071101</startdate><enddate>20071101</enddate><creator>NG, Shamay S. M</creator><creator>HUI-CHAN, Christina W. Y</creator><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>7X8</scope></search><sort><creationdate>20071101</creationdate><title>Transcutaneous electrical nerve stimulation combined with task-related training improves lower limb functions in subjects with chronic stroke</title><author>NG, Shamay S. M ; HUI-CHAN, Christina W. Y</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c449t-7d19dfa3afaad5a8c026d1aabb2a49475b143d3c9d3ca220a19e19c9c07be11c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Activities of Daily Living</topic><topic>Afferent Pathways - physiology</topic><topic>Aged</topic><topic>Analgesics</topic><topic>Ankle Joint - physiology</topic><topic>Biological and medical sciences</topic><topic>Chronic Disease</topic><topic>Electric Stimulation Therapy - methods</topic><topic>Exercise Therapy - methods</topic><topic>Female</topic><topic>Gait Disorders, Neurologic - etiology</topic><topic>Gait Disorders, Neurologic - physiopathology</topic><topic>Gait Disorders, Neurologic - rehabilitation</topic><topic>Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy</topic><topic>Home Care Services</topic><topic>Humans</topic><topic>Lower Extremity - innervation</topic><topic>Lower Extremity - physiopathology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Movement - physiology</topic><topic>Muscle Spasticity - etiology</topic><topic>Muscle Spasticity - physiopathology</topic><topic>Muscle Spasticity - rehabilitation</topic><topic>Nervous system (semeiology, syndromes)</topic><topic>Neurology</topic><topic>Neuropharmacology</topic><topic>Paresis - etiology</topic><topic>Paresis - physiopathology</topic><topic>Paresis - rehabilitation</topic><topic>Peripheral Nerves - physiopathology</topic><topic>Pharmacology. Drug treatments</topic><topic>Range of Motion, Articular - physiology</topic><topic>Recovery of Function - physiology</topic><topic>Reflex, Stretch - physiology</topic><topic>Single-Blind Method</topic><topic>Stroke - complications</topic><topic>Stroke - physiopathology</topic><topic>Stroke Rehabilitation</topic><topic>Transcutaneous Electric Nerve Stimulation - methods</topic><topic>Treatment Outcome</topic><topic>Vascular diseases and vascular malformations of the nervous system</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>NG, Shamay S. M</creatorcontrib><creatorcontrib>HUI-CHAN, Christina W. Y</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Stroke (1970)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>NG, Shamay S. M</au><au>HUI-CHAN, Christina W. Y</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Transcutaneous electrical nerve stimulation combined with task-related training improves lower limb functions in subjects with chronic stroke</atitle><jtitle>Stroke (1970)</jtitle><addtitle>Stroke</addtitle><date>2007-11-01</date><risdate>2007</risdate><volume>38</volume><issue>11</issue><spage>2953</spage><epage>2959</epage><pages>2953-2959</pages><issn>0039-2499</issn><eissn>1524-4628</eissn><coden>SJCCA7</coden><abstract>Previous studies have shown that repeated sensory inputs could enhance brain plasticity and cortical motor output. The purpose of this study was to investigate whether combining electrically induced sensory inputs through transcutaneous electrical nerve stimulation (TENS) with task-related training (TRT) in a home-based program would augment voluntary motor output in chronic stroke survivors better than either treatment alone or no treatment.
Eighty-eight patients with stroke were assigned randomly to receive a home-based program of (1) TENS, (2) TENS+TRT, (3) placebo TENS+TRT, or (4) no treatment (control) 5 days a week for 4 weeks. Outcome measurements included Composite Spasticity Scale, peak torques generated during maximum isometric voluntary contraction of ankle dorsiflexors and plantarflexors, and gait velocity recorded at baseline, after 2 and 4 weeks of treatment, and 4 weeks after treatment ended.
When compared with TENS, the combined TENS+TRT group showed significantly greater improvement in ankle dorsiflexion torque at follow-up and in ankle plantarflexion torque at week 2 and follow-up (P<0.01). When compared with placebo+TRT, the TENS+TRT group produced earlier and greater reduction of plantarflexor spasticity and improvement in ankle dorsiflexion torque at week 2 (P<0.01). When compared with all 3 groups, the TENS+TRT group showed significantly greater improvement in gait velocity (P<0.01).
In patients with chronic stroke, 20 sessions of a combined TENS+TRT home-based program decreased plantarflexor spasticity, improved dorsiflexor and plantarflexor strength, and increased gait velocity significantly more than TENS alone, placebo+TRT, or no treatment. Such improvements can even be maintained 4 weeks after treatment ended.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>17901383</pmid><doi>10.1161/STROKEAHA.107.490318</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Stroke (1970), 2007-11, Vol.38 (11), p.2953-2959 |
| issn | 0039-2499 1524-4628 |
| language | eng |
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| source | MEDLINE; American Heart Association Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection; Journals@Ovid Complete |
| subjects | Activities of Daily Living Afferent Pathways - physiology Aged Analgesics Ankle Joint - physiology Biological and medical sciences Chronic Disease Electric Stimulation Therapy - methods Exercise Therapy - methods Female Gait Disorders, Neurologic - etiology Gait Disorders, Neurologic - physiopathology Gait Disorders, Neurologic - rehabilitation Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy Home Care Services Humans Lower Extremity - innervation Lower Extremity - physiopathology Male Medical sciences Middle Aged Movement - physiology Muscle Spasticity - etiology Muscle Spasticity - physiopathology Muscle Spasticity - rehabilitation Nervous system (semeiology, syndromes) Neurology Neuropharmacology Paresis - etiology Paresis - physiopathology Paresis - rehabilitation Peripheral Nerves - physiopathology Pharmacology. Drug treatments Range of Motion, Articular - physiology Recovery of Function - physiology Reflex, Stretch - physiology Single-Blind Method Stroke - complications Stroke - physiopathology Stroke Rehabilitation Transcutaneous Electric Nerve Stimulation - methods Treatment Outcome Vascular diseases and vascular malformations of the nervous system |
| title | Transcutaneous electrical nerve stimulation combined with task-related training improves lower limb functions in subjects with chronic stroke |
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