Effect of Functional Electrical Stimulation in Conjunction with Motor Relearning Program on Activities of Daily Living Following Ischemic Stroke: A Randomized Controlled Trial

Abstract

Background: Ischemic stroke frequently results in upper limb impairment, significantly affecting patients' ability to perform activities of daily living (ADL). Functional electrical stimulation (FES) combined with motor relearning programs has emerged as a promising rehabilitation approach for improving functional outcomes in stroke survivors. Objective: The present study evaluates the effectiveness of FES combined with motor relearning programs on ADL performance in patients with upper limb impairment following ischemic stroke. Methods: A randomised controlled trial was conducted with 84 ischemic stroke patients (mean age 58.4±12.3 years) with upper limb hemiplegia. Participants were randomly allocated to either the experimental group (n=42) receiving FES combined with motor relearning program, or the control group (n=42) receiving conventional physiotherapy. The intervention period was 6 weeks, with 5 sessions per week. The primary outcome measure was the Barthel Index (BI), and secondary outcomes included the Functional Independence Measure (FIM) and Canadian Occupational Performance Measure (COPM). Assessments were conducted at baseline, post-intervention (6 weeks), and follow-up (12 weeks). Results: Both groups showed significant improvements in ADL scores, but the experimental group demonstrated superior outcomes. At 6 weeks, the experimental group showed greater improvement in BI scores (mean difference: 15.8±8.4 vs. 8.2±6.1, p<0.001), FIM scores (mean difference: 22.3±10.7 vs. 12.1±7.9, p<0.001), and COPM performance scores (mean difference: 3.4±1.2 vs. 1.8±0.9, p<0.001). These improvements were maintained at 12-week follow-up. Conclusion: FES combined with motor relearning programs significantly enhances ADL performance in ischemic stroke patients compared to conventional therapy alone. This combined approach offers a potentially effective rehabilitation approach for improving functional independence in stroke survivors.