Effects of Neuromuscular Electrical Stimulation Combined With Upper Limb Neural Mobilization on Hand Grip and Range of Motion in Post Stroke Patients

Literature Review: In previous studies researcher compared Dynamic Neural Mobilization and Proprioceptive Neuromuscular Facilitation (PNF) in 30 sub-acute stroke patients, divided into two groups (15 each). Both groups received 30-minute sessions, 5 days/week for 4 weeks. Pre-test FMA-UE scores were 33.60±7.13 (Group A) vs. 32.60±9.85 (Group B), and grip strength 2.92±1.07 kg vs. 1.70±0.68 kg. Post-test scores improved to 41.00±7.07 and 5.12±2.03 kg (Group A), and 34.13±10.40 and 3.32±0.82 kg (Group B). Dynamic Neural Mobilization showed significantly better improvements in both outcomes.

A randomised controlled experiment with forty-three stroke patients who had hemiplegia in order to evaluate the impact of neural mobilisation in conjunction with shoulder control training,. The additional effect of neural mobilisation in stroke rehabilitation was supported by the treatment group's considerably higher improvements in upper limb motor function (FMA-UE) and shoulder pain (NRS) after four weeks when compared to the control group that received only shoulder training.

A qualitative review of 16 studies on neurodynamics in stroke patients, including 9 RCTs, 3 clinical trials, 3 systematic reviews, and 1 case study. Most studies reported that neurodynamics improved range of motion, flexibility, tone reduction, pain, nerve conduction, cortical activity, and post-stroke function. Only one RCT reported no effect on spasticity. Despite these benefits, the review concluded that evidence remains limited and more high-quality research is needed to validate neurodynamic techniques in stroke rehabilitation.

A case study of a 68-year-old male post-stroke patient with right-sided hemiparesis. The patient received Neuromuscular Electrical Stimulation combined with Proprioceptive Neuromuscular Facilitation (PNF) therapy for 4 sessions over 2 weeks. Post-treatment, improvements were noted in muscle strength and reduction of pain during passive flexion of the shoulder, elbow, and knee. The study concluded that Neuromuscular Electrical Stimulation and Proprioceptive Neuromuscular Facilitation (PNF) effectively promote muscle growth, strength, and pain relief in hemiparetic stroke patients.

A systematic review on the effectiveness of Neuromuscular Electrical Stimulation (NMES) for post-stroke spastic hemiparetic limbs. A total of 26 studies were screened, and 9 clinical studies were included (7 upper limb, 2 lower limb). Spasticity was assessed using Modified Ashworth Scale (MAS) and Electromyography. Most studies reported a decrease in spasticity lasting at least two weeks post-intervention. The authors concluded Neuromuscular Electrical Stimulation (NMES) is effective both alone or combined with physical therapy, while recommending further studies on Neuromuscular Electrical Stimulation (NMES) parameters.