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Review
. 2022 Feb 12;22(4):1409.
doi: 10.3390/s22041409.

Usability of Functional Electrical Stimulation in Upper Limb Rehabilitation in Post-Stroke Patients: A Narrative Review

Andreia S P Sousa  1 , Juliana Moreira  1 , Cláudia Silva  1 , Inês Mesquita  2 , Rui Macedo  1 , Augusta Silva  1 , Rubim Santos  3
Affiliations
Review

Usability of Functional Electrical Stimulation in Upper Limb Rehabilitation in Post-Stroke Patients: A Narrative Review

Andreia S P Sousa et al. Sensors (Basel). .

Abstract

Stroke leads to significant impairment in upper limb (UL) function. The goal of rehabilitation is the reestablishment of pre-stroke motor stroke skills by stimulating neuroplasticity. Among several rehabilitation approaches, functional electrical stimulation (FES) is highlighted in stroke rehabilitation guidelines as a supplementary therapy alongside the standard care modalities. The aim of this study is to present a comprehensive review regarding the usability of FES in post-stroke UL rehabilitation. Specifically, the factors related to UL rehabilitation that should be considered in FES usability, as well a critical review of the outcomes used to assess FES usability, are presented. This review reinforces the FES as a promising tool to induce neuroplastic modifications in post-stroke rehabilitation by enabling the possibility of delivering intensive periods of treatment with comparatively less demand on human resources. However, the lack of studies evaluating FES usability through motor control outcomes, specifically movement quality indicators, combined with user satisfaction limits the definition of FES optimal therapeutical window for different UL functional tasks. FES systems capable of integrating postural control muscles involving other anatomic regions, such as the trunk, during reaching tasks are required to improve UL function in post-stroke patients.

Keywords: functional electrical stimulation; rehabilitation; stroke.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Summary of the main arguments that sustain the use of FES as a strategy to improve UL function.
Figure 2
Figure 2
Advantages of NMES and FES-based systems.
Figure 3
Figure 3
Demonstration on how FES could increase neuronal functional connectivity in post-stroke patients.
Figure 4
Figure 4
Representation of two tasks of different levels of motor control complexity assisted by multifield FES, drinking task (on the left) and turn on the light tasks (on the right).
Figure 5
Figure 5
Summary of kinematics measures that should be considered to assess the influence of multifield FES in UL movement quality.
See this image and copyright information in PMC

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References

    1. Murray C.J.L., Vos T., Lozano R., Naghavi M., Flaxman A.D., Michaud C., Ezzati M., Shibuya K., Salomon J.A., Abdalla S., et al. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: A systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380:2197–2223. doi: 10.1016/S0140-6736(12)61689-4. - DOI - PubMed
    1. Lv Y., Sun Q., Li J., Zhang W., He Y., Zhou Y. Disability Status and Its Influencing Factors Among Stroke Patients in Northeast China: A 3-Year Follow-Up Study. Neuropsychiatr. Dis. Treat. 2021;17:2567–2573. doi: 10.2147/NDT.S320785. - DOI - PMC - PubMed
    1. Intercollegiate Stroke Working Party . National Clinical Guideline for Stroke. Royal College of Physicians; London, UK: 2012.
    1. Lawrence E.S., Coshall C., Dundas R., Stewart J., Rudd A.G., Howard R., Wolfe C.D.A. Estimates of the Prevalence of Acute Stroke Impairments and Disability in a Multiethnic Population. Stroke. 2001;32:1279–1284. doi: 10.1161/01.STR.32.6.1279. - DOI - PubMed
    1. Kwakkel G., Kollen B.J., van der Grond J., Prevo A.J. Probability of Regaining Dexterity in the Flaccid Upper Limb: Impact of Severity of Paresis and Time since Onset in Acute Stroke. Stroke. 2003;34:2181–2186. doi: 10.1161/01.STR.0000087172.16305.CD. - DOI - PubMed