Article

The aim of this educational review is to provide an overview of the clinical
application of transcutaneous electrical stimulation of the extremities in
patients with upper motor neurone lesions. In general two methods of electrical
stimulation can be distinguished: (i) therapeutic electrical stimulation, and
(ii) functional electrical stimulation. Therapeutic electrical stimulation
improves neuromuscular functional condition by strengthening muscles, increasing
motor control, reducing spasticity, decreasing pain and increasing range of
motion. Transcutaneous electrical stimulation may be used for neuromuscular
electrical stimulation inducing repetitive muscle contraction,
electromyography-triggered neuromuscular electrical stimulation,
position-triggered electrical stimulation and subsensory or sensory
transcutaneous electric stimulation. Functional electrical stimulation provokes
muscle contraction and thereby produces a functionally useful movement during
stimulation. In patients with spinal cord injuries or stroke, electrical upper
limb neuroprostheses are applied to enhance upper limb and hand function, and
electrical lower limb neuroprostheses are applied for restoration of standing and
walking. For example, a dropped foot stimulator is used to trigger ankle
dorsiflexion to restore gait function. A review of the literature and clinical
experience of the use of therapeutic electrical stimulation as well as of
functional electrical stimulation in combination with botulinum toxin, exercise
therapy and/or splinting are presented. Although the evidence is limited we
conclude that neuromuscular electrical stimulation in patients with central
nervous system lesions can be an effective modality to improve function, and that
combination with other treatments has an additive therapeutic effect.

Langue : ANGLAIS