Effect of Bilateral TENS With TOT on Upper Limb Function in Patients With Chronic Stroke

A Randomized, Controlled Clinical Trial of Upper Limb Training With Bilateral Cutaneous Electrical Stimulation to Improve Upper Limb Functions in Patients With Chronic Stroke

On the basis that the combined use of Uni-TENS and TRT is an effective intervention in upper limb recovery, and the advantage of Bi-TENS eliciting extra neural pathway in the intact hemisphere to facilitate the motor recovery, There is a research gap in whether the Bi-TENS over both the paretic and non-paretic limbs could probably augment the treatment effects of TOT in upper limb motor control in people with stroke.

The purpose of this study is to determine whether Bi-TENS+TOT was superior to Uni-TENS+TOT, Placebo-TENS+TOT alone and no active treatment in improving the upper limb motor control and upper limb function and community integration in people with chronic stroke.

The null hypothesis will be that Bi-TENS+TOT is not significantly different from Uni-TENS+TOT,Placebo-TENS+TOT alone and no active treatment in improving the upper limb motor control and upper limb function and community integration in people with chronic stroke.

Inclusion Criteria:

• Subjects will be recruited from local self-help groups through poster advertising.
• Subjects will be included if they are between 50 and 80 years of age
• Have been diagnosed with ischaemic brain injury or intracerebral hemorrhage by MRI or computed tomography within the previous 1 to 10 years
• have volitional control of the non-paretic arm and at least minimal antigravity movement in the shoulder of the paretic arm,
• have at least 5º in wrist extension in the antigravity position,
• score > 6 out of 10 in the Abbreviated Mental Test, and
• are able to follow instructions and give informed consent.

Exclusion Criteria:

• • have any additional medical, cardiovascular or orthopedic condition

  • use a cardiac pacemaker
  • have receptive dysphasia
  • have a significant upper limb peripheral neuropathy
  • are involved in drug studies or other clinical trials, or
  • have severe shoulder, elbow, wrist or finger contractures that would preclude a passive range of motions of the arm, and
  • have a skin allergy that would prevent electrical stimulation.