| Methods |
Design: Randomised controlled trial, parallel groups.
Randomisation: Prospective generated random order into which participants were placed.
Dropouts: None reported. |
| Participants |
Experimental: n = 14, 9 male and 8 right hemisphere lesion. Mean age 50.1 (28‐74 years and mean time after stroke 56.1 (23‐94) days.
Control: n = 14, 8 male and 5 right hemisphere lesion. Mean age 54 (37‐72) years and mean time after stroke 61.6 (26‐170) days.
Study criteria: (1) right‐handed stroke patients; (2) large supratentorial cerebrovascular lesions, ischaemic or haemorrhagic; (3) no previous stroke; (4) no dementia; (5) no bilateral lesions; (6) clinically stable; (7) hemiparesis. |
| Interventions |
Duration: 4 weeks.
Experimental:
Category = 5.
Transcutaneous electrical stimulation triggered by voluntary EMG activity in the target muscle (upper ar extensors, forearm hand extensors, knee flexors, ankle extensors) to produce joint movements. Each group of muscles was stimulated 15 times during each session given 5 times a week for 4 weeks. The stimulus was set to achieve a maximum effect of movement but not of force. The level of voluntary EMG activity required to trigger stimulation was approximately 80% of the maximum surface EMG activity. Stimulus was 0.3 ms biphasic sinus wave pulses at 80Hz with a constant current of 20 to 60mA for 1 second. All experimental participants received the control intervention.
Control:
Conventional physiotherapy based on the principles of Bobath. Occupational therapy also provided. Therapy given for 45 minutes 5 times a week.
Comparison: Electrostimulation vs no treatment. |
| Outcomes |
Baseline measurement: Pre‐intervention.
Outcome measurement: 1 week after intervention ended.
Included outcomes: (1) spasticity relaxation index knee; (2) spasticity relaxation index elbow; (3) active range of movement ankle extensors; (4) active range of movement hand extensors; (5) Barthel Index
Other outcomes: (1) spasticity overall score upper limb: (2) spasticity overall score lower limb; (3) clonus; (4) deep tendon reflex activity. |
| Notes |
Omitted overall spasticity scores as score was 0 = flaccid, 1 = normal up to 3 = hyperexcitable. Therefore not always possible to say that a higher score indicated an increase in abnormality of spasticity. |
| Risk of bias |
| Bias |
Authors' judgement |
Support for judgement |
| Allocation concealment? |
Unclear risk |
B ‐ Unclear |
