Efficacy and Safety of Early Neuromuscular Electrical Stimulation on Shoulder and Arm Paresis in Patients of Acute Ischaemic Stroke-A Quasi-experimental Study.

Background: Shoulder subluxation and shoulder pain are frequent after a stroke. Neuromuscular electrical stimulation (NMES) has been used widely in the sub-acute and chronic stages, but its use in the early stage is infrequent.

Aims and objectives: The study's objective is to see the effect of early neuromuscular electrical stimulation on hand function, shoulder subluxation, and shoulder pain after three months of stroke.

Methods: This study included 60 acute ischaemic stroke survivors. The intervention group received early NMES with standard rehabilitation, whereas the control group only received standard rehabilitation. The assessment was done at baseline and three months follow-up. The outcome measures were the presence of a sulcus sign, the Numerical Rating Scale (NRS), the Fugl-Meyer Assessment-Upper Extremity (FMA-UE, sub-scale A and A-D) and the Motor Activity Log (MAL) (sub-scale HOW WELL and AMOUNT).

Result: The intervention group had eight patients and the control group had nine patients with shoulder subluxation at follow-up. Hand functional outcomes were significantly better in the intervention group compared to the control group, with the FMA-UE-A scores of 27 (19-36) versus 18.5 (4.7-24.75), p = .007 and FMA-UE-A-D scores of 28.5 (4-48.25) versus 7.5 (4-23.75), p = .011. The HOW WELL and AMOUNT scores also showed significant differences, with 90 (30-150) versus 30 (0-90), p = .027. The intervention group did not experience any adverse events related to NMES.

Conclusion: The application of early NMES prevents shoulder subluxation and improves hand function. Randomised control trials with larger sample sizes and additional treatment sessions are needed to generalise the results.