Neuromuscular Electrical Stimulation (NMES) in Stroke-diagnosed Individuals

Our study will be carried out in Fırat University Training and Research Hospital. Individuals who are diagnosed with stroke by the Physical Medicine and Rehabilitation Specialist and who are directed to the physiotherapy program will be included. 20 hemiparesis patients who underwent stimulation and conventional physiotherapy and rehabilitation of the back extensors, will constitute 20 volunteer patients who only provided conventional physiotherapy and rehabilitation applications. 20 cases were included in the study and 20 cases as control group. All cases will be informed and approved before they start working.

Inclusion Criteria

1. Having a chart of hemiplegia or hemiparesis due to the first story of cerebrovascular accident (SVO)

2. At least 3 months after SVO

3. Mini-mental State Examination (MMSE) value ≥ 15

4. Being in the 30 to 80 age range

5. Back extensor muscle spasticity value <4 according to modified Ashworth Scale

Criteria for Inclusion of Patients in the Study

1. Ataxia, dystonia, dyskinesia

2. The presence of lower motor neuron or peripheral nerve lesion

3. Degraded deep senses

4. Detection disorder and dementia

5. Skin and peripheral circulatory disorder

6. History of CVO, bilateral hemiplegia

As demographic characteristics; age, gender, body weight, height of the patients, the hand (dominant hemisphere), occupation and educational status, as a history of the disease; It will be noted whether the patient has undergone SVO or transient ischemic attack. Our neurological evaluation form; Reflexes, sensory defects, cranial nerve lesion, visual disturbances, speech problem and type will be recorded.

All patients will be evaluated after treatment (TS). Spasticity will be graded from 0 to 5 according to the Modified Ashworth Scale.

Postural Assesment of Stroke Scale (PASS), Short Form-36, Adapted Patient Evaluation and Conference System, Stroke Rehabilitation Assesment of Movement (STREAM), Brunel Balance Assessment (BBA), Functional Ambulation Scale(FAS) and Mini-Mental State Examination (MMSE) surveys and scales will be used.

Stimulation program, symmetrical biphasic waveform, 50 Hz frequency, 400 μs width flow characteristics are used and the duration of treatment should be 30 min.

The current density will be adjusted to give full contraction of the back extensor muscle at each warning. It will be adjusted separately in each session without any discomfort or pain. In cases where contraction is reduced, the intensity of the current will be increased to achieve the same quality contraction. However, the target muscles outside the muscles will spread to the muscles strong enough to be created.

Statistical analysis of the study will be done with Statistical Package for Social Sciences (SPSS) Version IBM Statistic 20. Mann Whitney U test will be used for the differences between the two groups. Comparisons between the pre-treatment and post-treatment values of the patients will be done by Wilcoxon Signed Rank test in dependent groups.

The obtained values will be expressed as mean ± standard deviation (SD). The differences below p <0.05 would be considered significant.