Effects of mental activity training linked with electromyogram-triggered electrical stimulation on paretic upper extremity motor function in chronic stroke patients: A pilot trial

Objective: To study whether mental activity training linked with electromyogram-triggered electrical stimulation (MAT-EMG) improves motor function of a paretic upper extremity in chronic stroke patients. Materials and Methods: Eighteen patients with chronic stroke for more than 12 months were included in the study. Nine patients were randomly allocated to MAT-EMG and 9 to generalized functional electrical stimulation (FES) on the forearm extensor muscles of the paretic extremity 20 times over 4 weeks, for 40 minutes/session. Outcome measures were: active range of motion (ROM) of the wrist joint, strength of the forearm extensor muscles, the modified Ashworth scale (MAS), Fugl-Meyer motor assessment for the upper extremity (FMM-UE), motor activity log (MAL) and the modified Barthel index (MBI) scores. Results: The group receiving MAT-EMG improved by 6.13 points in FMM-UE scores (p<0.05), and the group receiving FES improved by 1.13 points, after intervention. There was a significant difference in FMM-UE scores between the two groups. This was caused by the noticeable increase in the FMM-UE wrist and shoulder scales in the MAT-EMG group. However, nosignificant difference was observed in other measures between the groups. Conclusion: We found that MAT-EMG had a greater effect than FES on recovery of motor function in the paretic extremities of chronic stroke patients.