Purposeful Activity-Based Electrical Stimulation Improves Activities of Daily Living in Patients with Subacute Stroke and Moderate-to-Severe Upper Limb Hemiparesis: A Pilot Randomised Controlled Trial

PurposeIn this randomised controlled trial study, we aimed to preliminarily evaluate the effectiveness of purposeful activity-based electrical stimulation therapy (PA-EST) in improving independence in daily living in patients with stroke and moderate-to-severe upper limb hemiparesis.MethodsThis study was conducted in the rehabilitation ward of Kyoto Ohara Memorial Hospital, Japan. Sixteen rehabilitation ward inpatients who experienced stroke and moderate-to-severe upper limb hemiparesis were included. In this randomised controlled trial, the participants were randomly assigned to either PA-EST or conventional occupational therapy (COT) and received a 2-month intervention. The primary outcome measures included motor, cognitive, and total scores on the functional independence measure (FIM). The secondary outcome measures included the Motor Activity Log (MAL), Amount of Use and Quality of Movement (QOM) subscales, and the Upper Extremity, Lower Extremity, and Total Fugl-Meyer Assessment scores.FindingsTwo-way repeated measures analysis of variance revealed significant interactions for FIM-motor (p = 0.041), FIM-total (p = 0.029), and MAL-QOM (p = 0.005), with greater improvements in the PA-EST group than in the COT group. No significant interactions were observed for the other outcome measures.ConclusionsThis randomised controlled trial study provides preliminary evidence that PA-EST may enhance activities of daily living independence in patients with subacute-phase stroke and moderate-to-severe upper limb hemiparesis. These findings support the clinical utility of PA-EST as a novel intervention strategy for advancing stroke rehabilitation.