Effects of Neuromuscular Electrical Stimulation on Flexor Spasticity and Function in Stroke Patients

Effects of Neuromuscular Electrical Stimulation Applied to Agonist or Antagonist Muscles of the Upper Extremity on Flexor Spasticity and Function in Patients With Stroke

In this study, the investigators aimed to determine the effects of botulinum neurotoxin type A injections for wrist and finger flexor spasticity and neuromuscular electrical stimulation therapy applied to wrist and finger flexors or extensors on upper extremity flexor spasticity and function in stroke patients.

Neuromuscular electrical stimulation therapy applied to wrist and finger flexors (agonist application) or wrist and finger extensors (antagonist application) after botulinum neurotoxin type A injections in stroke patients with wrist and finger flexor spasticity in upper extremity flexor spasticity, To determine the effects on motor recovery, upper extremity and hand functions, hand grip strength, range of motion, functional independence, quality of life, hand skills and sonographically evaluated muscle thickness and to compare these different applications.

Inclusion Criteria:

1. Diagnosed with ischemic or hemorhagic stroke after imaging with CT/MRI
2. First time stroke survivor
3. between 45-75 years old
4. Stroke duration > 3 months
5. Neurologically stable
6. Affected wrist and finger flexor muscle spasticity with MAS≥2
7. Patients whose cognitive status is at a level to understand the study instructions MMT> 23)

Exclusion Criteria:

1. Presence of another neurological disorder other than stroke causing motor impairment/spasticity
2. Fixed contracture in the hand-wrist
3. Use of medical treatment for spasticity
4. Having received neurolytic therapy, BoNT-A injection or NMES treatment in the last 3 months
5. Skin problem (disease, allergy, infection, etc.) on the contact surface of the NMES
6. Complex regional pain syndrome (CRPS), sequelae of previous trauma or surgery (muscle tendon adhesion, peripheral nerve damage) in the affected extremity
7. Having a pacemaker
8. Epilepsy
9. Malignancy