| Methods |
Design: Randomised controlled trial, parallel groups.
Randomisation Computer generated randomisation order placed in sealed envelopes by an individual not involved in the study. Participants were randomised after baseline measures.
Dropouts: n = 5. Reasons were that participants died (n = 3) or they suffered a further neurological event (n = 2). |
| Participants |
Experimental: n = 30 recruited and 27 completed treatment. Of the 30 participants recruited, 18 had a left hemiparesis, their mean age was 60 (SD 10.8) years and the mean time after stroke was 23.9 (SD 7.7) days.
Control: n = 30 recruited and 28 completed treatment. Of the 30 participants recruited, 20 had a left hemiparesis, their mean age was 66.4 (SD 12.2) years and the mean time after stroke was 22.9 (SD 5.5) days.
Study criteria: (1) intracerebral haemorrhage or infarction confirmed by CT scan; (2) hemiparesis due to acute stroke; (3) MRC grade of wrist extensors 4/5 or worse at 2/4 weeks after stroke; (4) no previous wrist problem; (5) able to understand the study. |
| Interventions |
Duration: 8 weeks.
Experimental:
Category = 7.
Electrostimulation of wrist and finger extensors with external electrodes placed for optimally balanced joint movement. Pulse width of 300ms, frequency of 20Hz, amplitude set at minimum level required to produce full wrist extension. Stimulation on time of 5 seconds included 1 second ramping up period and a 1.5 second ramping down period. The muscle contract/relax ratio was progressively increased by shortening the relaxation time from 5/20 on/off to 5/5 seconds on/off. The intervention was given in 30 minute sessions, 3 times a day for 8 weeks. All experimental participants also received the standard therapy given to the control group.
Control:
Standard therapy from the ward rehabilitation team using a combination of Bobath and Movement Science approaches depending on individual patient needs. All control participants also received a visit of up to 10 minutes three times a week from the therapist providing the experimental intervention. This visit was to discuss rehabilitation progress with the aim of controlling for the extra attention given to the experimental group.
Comparison: Electrostimulation vs no treatment. |
| Outcomes |
Baseline measurement: Before intervention.
Outcome measurement: After 8 weeks of intervention.
Included outcomes: (1) isometric torque about the wrist at 0 degrees; (2) muscle tone ‐ Ashworth; (3) grip strength; (4) ARAT score; (5) 9HPT; (6) Barthel Index.
Other outcomes: (1) resting angle of wrist; (2) end range angle for passive range of motion at wrist; (3) end range for active range of motion at wrist. |
| Notes |
The intention‐to‐treat principle was not followed in data analysis. |
| Risk of bias |
| Bias |
Authors' judgement |
Support for judgement |
| Allocation concealment? |
Low risk |
A ‐ Adequate |
