| Methods |
Design: Randomised controlled trial, three parallel groups (2 groups included in this review see notes below).
Randomisation: 'The randomisation procedure was consistent with recommendations by Altman and Schulz' (Altman, Schulz. BMJ 2001;323:446‐7).
Dropouts: None recorded. |
| Participants |
n = 16.
Experimental: n = 10, 6 female and 8 left hemisphere strokes.
Control: n = 6, 2 female and 3 left hemisphere stroke.
Study criteria: (1) suffered a stroke more than 12 months before recruitment; (2) partial paralysis in wrist/fingers; (3) difficulty voluntarily initiating and controlling extension movements; (4) diagnosis of no more than 2 strokes on the same side of the brain; (5) able to extend 10 degrees from a 90 degree wrist flexed position but no more than 80% motor recovery as indicated by comparing the rectified EMG activation patterns and sustained force contractions of the impaired and unimpaired limbs; (6) absence of other neurological deficits; (7) able to follow directions. |
| Interventions |
Duration: 2 weeks.
Experimental:
Category = 5.
EMG‐triggered electrostimulation to take muscles into full range wrist/finger extension. Electrostimulation given for 5 seconds with a 1 second ramp up, biphasic stimulation at 50 Hz, mA range of 17‐28, pulse width of 200 ms and 1 second ramp down. Training given for 6 hours across 4 days in a 2 week period. All experimental participants also received the control intervention.
Control: Bilateral movement training consisting of mirror movements on the unimpaired wrist/fingers simultaneously with the initiation of the impaired wrist/fingers extension movement attempts. Training given for 6 hours across 4 days in a 2 week period.
Comparison: Electrostimulation vs no treatment. |
| Outcomes |
Baseline measurement: Pre‐intervention.
Outcome measurement: After intervention at 2 weeks.
Included outcomes: (1) Box and Blocks test; (2) sustained muscle contraction; (3) pre‐motor reaction time unilateral.
Other outcomes: (1) pre‐motor reaction time bilateral. |
| Notes |
This study also examined the effects of providing electrostimulation for 5 second as well as 10 second bursts. However, these data were not included in analysis as data could not be combined. We therefore included the 10 second data in the analysis as this condition provided a higher intensity of treatment. |
| Risk of bias |
| Bias |
Authors' judgement |
Support for judgement |
| Allocation concealment? |
Low risk |
A ‐ Adequate |
