Effect of Underwater Electrical Stimulation on Hand Grip Strength in Stroke Patients

Effects of Underwater Electrical Faradic Stimulation on Hand Grip Strength and Upper Extremity Motor Recovery in Sub-acute Post-Stroke Patients: A Double-Blinded, Randomized Placebo-Controlled Trial

This study evaluates the therapeutic effects of underwater electrical faradic stimulation delivered via a four-cell hydrotherapy bath on hand grip strength and upper limb motor recovery in subacute post-stroke hemiplegic patients.

Upper extremity motor impairment remains a major cause of persistent disability following subacute stroke. Forty-four participants with subacute post-stroke hemiparesis were recruited and randomized in a 1:1 ratio to either an experimental group or a placebo control group. Both groups received 12 treatment sessions across 4 consecutive weeks (3 sessions per week, 20 minutes per session). Group A received active underwater faradic current stimulation applied to the affected upper limb in a four-cell hydrotherapy bath. Group B underwent identical limb positioning and bath immersion with 0 mA current output. Hand grip strength (HGS) via Jamar dynamometry and motor function via the Fugl-Meyer Assessment for Upper Extremity (FMA-UE) were assessed at baseline and post-intervention.

Inclusion Criteria:

• First-ever ischemic or hemorrhagic stroke in the subacute phase (<6 months post-onset) confirmed by neuroimaging (CT or MRI).
• Chronological age ranging from 50 to 65 years.
• Gross Motor Function Classification System (GMFCS) Level I or II (capable of walking 10 meters independently without physical support or handheld mobility aids).

Exclusion Criteria:

• Severe cognitive impairments or receptive language deficits precluding the ability to follow verbal instructions or communicate with research staff.
• Concurrent participation in other interventional clinical trials.
• Prior history of other neurological, severe musculoskeletal, or psychiatric disorders affecting upper limb function.
• Presence of skin lesions, open wounds, or severe peripheral vascular disease in the affected upper extremity.