Ann Rehabil Med.  2018 Oct;42(5):652-659. 10.5535/arm.2018.42.5.652.

Comparison Between Neuromuscular Electrical Stimulation to Abdominal and Back Muscles on Postural Balance in Post-stroke Hemiplegic Patients

• Park M
• Seok H
• Kim SH
• Noh K
• Lee SY

• KMID: 2429194
• DOI: http://doi.org/10.5535/arm.2018.42.5.652

Abstract

OBJECTIVE
To compare the effects of neuromuscular electrical stimulation (NMES) to abdominal muscles and back muscles on postural balance in post-stroke hemiplegic patients.
METHODS
Thirty post-stroke hemiplegic patients were prospectively enrolled and randomly assigned to one of the three groups: core muscle-strengthening exercise (CME) with NMES to abdominal muscles (group A), CME with NMES to back muscles (group B), and CME alone (group C). All subjects underwent their targeted interventions for 30 minutes each day, 5 days per week for 3 weeks under a conventional stroke rehabilitation program. Subjects were evaluated using Korean version of Berg Balance Scale (K-BBS), Trunk Impairment Scale (TIS), Korean version of Modified Barthel Index (K-MBI), Weight Distribution Index (WDI), and Stability Index (SI) just before and 3 weeks after intervention.
RESULTS
Changes in K-BBS (p < 0.05) and TIS (p < 0.05) were significantly higher in group A (18.5±8.10, 6.6±1.90) and group B (19.9±5.44, 7.0±2.26) than in group C (8.4±4.14, 3.1±0.99). However, K-MBI, WDI, and SI failed to show any significant difference. No significant difference in all outcomes was observed between groups A and B.
CONCLUSION
The effect of NMES to the abdominal muscles was similar to the effect on back muscles in terms of postural balance. This finding indicated that the NMES to the abdominal muscles may be an alternative for post-stroke hemiplegic patients contraindicated for NMES to the back muscles. Additional studies investigating the effects of NMES on abdominal and back muscles are needed.

Keyword

Stroke; Abdominal muscles; Electrical stimulation; Postural balance

MeSH Terms

Abdominal Muscles
Back Muscles*
Electric Stimulation*
Humans
Postural Balance*
Prospective Studies
Rehabilitation
Stroke

Figure

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  Fig. 1. Flow diagram of the study. CME, core muscle strengthening exercise; NMES, neuromuscular electrical stimulation.

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  Fig. 2. Surface electrodes were attached to abdominal muscles bilaterally at 4 sites. Two electrodes were attached 1 cm superior to the iliac crest along the midaxillary line, and the remaining electrodes 2 cm superior and 2 cm medial to the anterior superior iliac spine.

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  Fig. 3. Surface electrodes were attached to back muscles bilaterally at 4 site. Two 5 cm lateral to the T6 spinous process, the rest 2 cm lateral to the L5 spinous process.

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  Fig. 4. (A) Static posturographic device (Tetrax). (B) Four reference points (bilateral toe and heel parts) were used to determine the pressure.

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