The Effectiveness of High Intensity Electromagnetic Stimulation in Spastic Stroke Patients : The Effectiveness of High Intensity Electromagnetic Stimulation

Muslim Khan; Aftab  Ali; Zakir  Khan; Abid  Jan; Shah  Fahad; Samiullah  Khan; Mansoor  Ahmad; Rakan Abdullah  Alwabel

doi:10.54393/pbmj.v6i05.872

Authors

Muslim Khan Iqra National University, Swat, Pakistan
Aftab Ali Iqra National University, Swat, Pakistan
Zakir Khan Iqra National University, Swat, Pakistan
Abid Jan Khyber Medical University, Peshawar, Pakistan
Shah Fahad Iqra National University, Swat, Pakistan
Samiullah Khan Iqra National University, Swat, Pakistan
Mansoor Ahmad Iqra National University, Swat, Pakistan
Rakan Abdullah Alwabel Ministry of Health, Saudi Arabia

DOI:

https://doi.org/10.54393/pbmj.v6i05.872

Keywords:

Stroke, Spasticity, High Intensity Electromagnetic Stimulation (EMS)

Abstract

In stroke patients, spasticity level allows to predict the patient’s rehabilitation outcome. Objective: To evaluate the anti-spastic effectiveness of high intensity electromagnetic stimulation (HIES) in stroke patients. Methods: Twenty (n=20) spastic stroke patients were assigned randomly into two groups; the study participants were briefed about the aim & methodology of the study & written consent were taken. Ten therapy sessions were given to the stroke’s patient spastic muscles in the treatment group (TG) with HIES, while in the controlled group (CG) 10 electrotherapy session along with kinesiotherapy was delivered. The outcome measures of the study were MAS (Modified Ashworth scale) & Barthel index (BI) was used as, for spasticity and for the patient’s quality life evaluation, respectively. After the one-month therapeutic plan results were obtained & compared based on the pre-treatment score & post-treatment score on the afore-mentioned specified outcome measures. Results: The analysis of data shows that treatment group score improved significantly, up to 68% & similarly, spasticity decreased from 2.86±0.075 in the beginning to 0.58±0.86 points on MAS, while on the other hand, control group score up to 31% enhanced & on the MAS scale, spasticity diminished from 2.45±0.57 in the start to 1.49±0.87 points. As per Barthel index, improvement for CG & TG was 72% & 80% respectively. Conclusions: This study results shows that high intensity electromagnetic stimulation (EMS) is highly effective in the reduction of stroke-specific spasticity.

References

Prouza O, Kouloulas E, Zarkovic D. High-Intensity Electromagnetic Stimulation Can Reduce Spasticity in Post-Stroke Patients. International Journal of Physiotherapy. 2018 Jun: 5(3): 87-91. doi: 10.15621/ijphy/2018/v5i3/173931. DOI: https://doi.org/10.15621/ijphy/2018/v5i3/173931

Ruschil C, Dubois E, Stefanou MI, Kowarik MC, Ziemann U, Schittenhelm M, et al. Treatment of progressive multiple sclerosis with high-dose all-trans retinoic acid–no clear evidence of positive disease modifying effects. Neurological Research and Practice. 2021 Dec; 3(1): 1-10. doi: 10.1186/s42466-021-00121-4. DOI: https://doi.org/10.1186/s42466-021-00121-4

Yu WY, Ma LX, Tian Y, Mu JD, Zhang Z, Sun TY, et al. Acupuncture alleviates menstrual pain in rat model via suppressing Eotaxin/CCR3 axis to weak EOS-MC activation. Evidence-Based Complementary and Alternative Medicine. 2022 Jan; 2022: 4571981. doi: 10.1155/2022/4571981. DOI: https://doi.org/10.1155/2022/4571981

Liu Y, Chen YT, Zhang C, Zhou P, Li S, Zhang Y. Motor Unit Number Estimation in Spastic Biceps Brachii Muscles of Chronic Stroke Survivors Before and After BoNT Injection. IEEE Transactions on Biomedical Engineering. 2022 Sep; 70(3): 1045-52. doi: 10.1109/TBME.2022.3208078. DOI: https://doi.org/10.1109/TBME.2022.3208078

Mohammadi A, Fard MR, Ma L, Mu J, Sun T, Yu W, et al. Analgesic effects and hemodynamic mechanisms of perpendicular and transverse needling at Sanyinjiao (SP 6) in patients with primary dysmenorrhea: a randomized controlled trial. Journal of Traditional Chinese Medical Sciences. 2021 Jul; 8(3): 248-56. doi: 10.1016/j.jtcms.2021.07.002. DOI: https://doi.org/10.1016/j.jtcms.2021.07.002

Yu WY, Ma LX, Zhang Z, Mu JD, Sun TY, Tian Y, et al. Acupuncture for primary dysmenorrhea: a potential mechanism from an anti-inflammatory perspective. Evidence-Based Complementary and Alternative Medicine. 2021 Dec; 2021: 1907009. doi: 10.1155/2021/1907009. DOI: https://doi.org/10.1155/2021/1907009

Härtig F, Birschmann I, Peter A, Hörber S, Ebner M, Sonnleitner M, et al. Point-of-care testing for emergency assessment of coagulation in patients treated with direct oral anticoagulants including edoxaban. Neurological Research and Practice. 2021 Dec; 3: 1-9. doi: 10.1186/s42466-021-00105-4. DOI: https://doi.org/10.1186/s42466-021-00105-4

Yoldaş Aslan Ş, Kutlay S, Düsünceli Atman E, Elhan AH, Gök H, Küçükdeveci AA. Does extracorporeal shock wave therapy decrease spasticity of ankle plantar flexor muscles in patients with stroke: A randomized controlled trial. Clinical Rehabilitation. 2021 Oct; 35(10): 1442-53. doi: 10.1177/02692155211011320. DOI: https://doi.org/10.1177/02692155211011320

Hsu PC, Chang KV, Chiu YH, Wu WT, Özçakar L. Comparative effectiveness of botulinum toxin injections and extracorporeal shockwave therapy for post-stroke spasticity: a systematic review and network meta-analysis. EClinical Medicine. 2022 Jan; 43: 101222. doi: 10.1016/j.eclinm.2021.101222. DOI: https://doi.org/10.1016/j.eclinm.2021.101222

Vinolo-Gil MJ, Rodríguez-Huguet M, García-Muñoz C, Gonzalez-Medina G, Martin-Vega FJ, Martín-Valero R. Effects of peripheral electromagnetic fields on spasticity: a systematic review. Journal of Clinical Medicine. 2022 Jun; 11(13): 3739. doi: 10.3390/jcm11133739. DOI: https://doi.org/10.3390/jcm11133739

Li D, Cheng A, Zhang Z, Sun Y, Liu Y. Effects of low-frequency repetitive transcranial magnetic stimulation combined with cerebellar continuous theta burst stimulation on spasticity and limb dyskinesia in patients with stroke. BMC Neurology. 2021 Dec; 21(1): 1-8. doi: 10.1186/s12883-021-02406-2.

Moon SW, Kim JH, Jung MJ, Son S, Lee JH, Shin H, et al. The effect of extracorporeal shock wave therapy on lower limb spasticity in subacute stroke patients. Annals of Rehabilitation Medicine. 2013 Aug; 37(4): 461-70. doi: 10.5535/arm.2013.37.4.461. DOI: https://doi.org/10.5535/arm.2013.37.4.461

In TS, Jung JH, Jung KS, Cho HY. Effectiveness of transcutaneous electrical nerve stimulation with taping for stroke rehabilitation. BioMed Research International. 2021 Aug; 2021: 9912094. doi: 10.1155/2021/9912094. DOI: https://doi.org/10.1155/2021/9912094

Kwon DR and Kwon DG. Botulinum toxin a injection combined with radial extracorporeal shock wave therapy in children with spastic cerebral palsy: shear wave sonoelastographic findings in the medial gastrocnemius muscle, preliminary study. Children. 2021 Nov; 8(11): 1059. doi: 10.3390/children8111059. DOI: https://doi.org/10.3390/children8111059

Kuzu Ö, Adiguzel E, Kesikburun S, Yaşar E, Yılmaz B. The effect of sham controlled continuous theta burst stimulation and low frequency repetitive transcranial magnetic stimulation on upper extremity spasticity and functional recovery in chronic ischemic stroke patients. Journal of Stroke and Cerebrovascular Diseases. 2021 Jul; 30(7): 105795. doi: 10.1016/j.jstrokecerebrovasdis.2021.105795. DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2021.105795

Wang X, Ge L, Hu H, Yan L, Li L. Effects of non-invasive brain stimulation on post-stroke spasticity: a systematic review and meta-analysis of randomized controlled trials. Brain Sciences. 2022 Jun; 12(7): 836. doi: 10.3390/brainsci12070836. DOI: https://doi.org/10.3390/brainsci12070836

Li D, Cheng A, Zhang Z, Sun Y, Liu Y. Effects of low-frequency repetitive transcranial magnetic stimulation combined with cerebellar continuous theta burst stimulation on spasticity and limb dyskinesia in patients with stroke. BMC Neurology. 2021 Dec; 21(1): 1-8. doi: 10.1186/S12883-021-02406-2. DOI: https://doi.org/10.1186/s12883-021-02406-2

In TS, Jung JH, Jung KS, Cho HY. Effect of sit-to-stand training combined with taping on spasticity, strength, gait speed and quality of life in patients with stroke: A randomized controlled trial. Life. 2021 May; 11(6): 511. doi: 10.3390/life11060511. DOI: https://doi.org/10.3390/life11060511

Hokazono A, Etoh S, Jonoshita Y, Kawahira K, Shimodozono M. Combination therapy with repetitive facilitative exercise program and botulinum toxin type A to improve motor function for the upper-limb spastic paresis in chronic stroke: A randomized controlled trial. Journal of Hand Therapy. 2022 Oct: 35(4): 507-15. doi: 10.1016/j.jht.2021.01.005. DOI: https://doi.org/10.1016/j.jht.2021.01.005

Lomovtsev I, Tsvetkova E, Gusakova E. Impact of Repetitive Peripheral Magnetic Stimulation on Post-Stroke Patients with Upper Limb Spasticity-A Randomized Controlled Trial. International Journal of Research in Physical Medicine & Rehabilitation. 2023 Feb; 1(1): 1-7.