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document
Transcutaneous electrical nerve stimulation combined with task-related training improves lower limb functions in subjects with chronic stroke . BACKGROUND AND PURPOSE Previous studies have shown that repeated sensory inputs could enhance brain plasticity and cortical motor output . The purpose of this study was to investigate whether combining electrically induced sensory inputs through transcutaneous electrical nerve stimulation ( TENS ) with task-related training ( TRT ) in a home-based program would augment voluntary motor output in chronic stroke survivors better than either treatment alone or no treatment . METHODS Eighty-eight patients with stroke were assigned randomly to receive a home-based program of ( 1 ) TENS , ( 2 ) TENS+TRT , ( 3 ) placebo TENS+TRT , or ( 4 ) no treatment ( control ) 5 days a week for 4 weeks . Outcome measurements included Composite Spasticity Scale , peak torques generated during maximum isometric voluntary contraction of ankle dorsiflexors and plantarflexors , and gait velocity recorded at baseline , after 2 and 4 weeks of treatment , and 4 weeks after treatment ended . RESULTS When compared with TENS , the combined TENS+TRT group showed significantly greater improvement in ankle dorsiflexion torque at follow-up and in ankle plantarflexion torque at week 2 and follow-up ( P < 0.01 ) . When compared with placebo+TRT , the TENS+TRT group produced earlier and greater reduction of plantarflexor spasticity and improvement in ankle dorsiflexion torque at week 2 ( P < 0.01 ) . When compared with all 3 groups , the TENS+TRT group showed significantly greater improvement in gait velocity ( P < 0.01 ) . CONCLUSIONS In patients with chronic stroke , 20 sessions of a combined TENS+TRT home-based program decreased plantarflexor spasticity , improved dorsiflexor and plantarflexor strength , and increased gait velocity significantly more than TENS alone , placebo+TRT , or no treatment . Such improvements can even be maintained 4 weeks after treatment ended .
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Intervention_Physical
Transcutaneous electrical nerve stimulation
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Intervention_Educational
combined with task-related training
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Intervention_Physical
transcutaneous electrical nerve stimulation ( TENS )
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Intervention_Educational
with task-related training ( TRT )
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Intervention_Physical
TENS , ( 2 ) TENS+TRT , ( 3 )
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Intervention_Control
placebo TENS+TRT
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Intervention_Physical
, or ( 4 )
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Intervention_Control
no treatment ( control )
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Intervention_Educational
TENS
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Intervention_Educational
TENS+TRT
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Intervention_Physical
placebo+TRT
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Intervention_Educational
TENS+TRT
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Intervention_Educational
combined TENS+TRT home-based
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Intervention_Educational
TENS
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Outcome_Physical
lower limb functions
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Outcome_Physical
brain plasticity
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Outcome_Physical
cortical motor output .
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Outcome_Physical
voluntary motor output
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Outcome_Physical
Composite Spasticity Scale
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Outcome_Physical
peak torques generated during maximum isometric voluntary contraction of ankle dorsiflexors and plantarflexors
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Outcome_Physical
ankle dorsiflexion torque
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Outcome_Physical
ankle plantarflexion torque
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Outcome_Physical
plantarflexor spasticity
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Outcome_Other
improvement in ankle dorsiflexion torque
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Outcome_Physical
gait velocity
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Outcome_Physical
decreased plantarflexor spasticity
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Outcome_Physical
improved dorsiflexor and plantarflexor strength
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Outcome_Physical
increased gait velocity