Electromyographically Triggered Electrical Stimulation on Shoulder Subluxation in Hemiplegic Stroke Patients

ABSTRACT

BACKGROUND: The aim of this study is to evaluate the effect of electromyographically triggered electrical stimulation (ETES) on shoulder subluxation in stroke patients. METHOD: Twenty-three patients, who had hemiplegic shoulder subluxation within 3 months after stroke attack, were included. They were assigned randomly to either a control group (11 subjects) or a study group (12 subjects), and divided clinically to mild and severe subgroups by the degree in subluxation. Patients in both groups were received physical therapy and used an arm-sling. Subjects in the study group were taken ETES using biofeedback training on posterior deltoid and the supraspinatus muscle of hemiplegic subluxation side, daily 30 minutes a session, five days a week for 6 weeks. Electromyographic signals, which are derived from patient's voluntary muscle contraction, that exceeded a preset threshold trigger an immediate stimulation to force movement completion. The effect of ETES was assessed by the degree of subluxation using radiologic measurements at pre-treatment and 6 weeks post-treatment. RESULTS: In the control group, the degree of subluxation was increased after 6 weeks (p>0.05). In the study group, the subluxation was significantly reduced (p<0.05). The significant difference after treatment 6 weeks in mild and severe subgroups implied similar improvement between subgroups. CONCLUSION: The ETES may be the one of effective treatment methods for reducing the severity of hemiplegic shoulder subluxation in stroke patients.