Preventieve armpositionering en elektrostimulatie bij CVA-patiënten.

Each year more than 41.000 people are struck by a stroke in the Netherlands. In more than 60% of the cases the hemiplegic arm remains without function. Disuse of the arm makes it prone to the occurrence of contracture formation and spasticity. This results in hemiplegic shoulder pain, motor impairments and activity limitations (e.g. cleaning the arm, dressing). Available evidence based single-modality treatments are not suitable for patients with poor motor performance, and severely affected patients are underrepresented in the research literature. Positioning procedures and electrical stimulation both seem best suitable for severely affected stroke patients and combining these treatment modalities may even be more efficacious. We hypothesize that the electrical stimulation intensifies the effect of the positioning procedure, resulting in slowing down of contracture formation, less hemiplegic shoulder pain, less restrictions in the stroke patient’s performance of activities of daily life, decreased levels of spasticity and prevention of subluxation.

N/A

Measurements will be made at baseline, after 4 weeks (intermediate), after 8 weeks (outcome) and after 20 weeks (follow-up).

The experimental group receives a standardised therapeutic procedure for the hemiplegic arm and simultaneous therapeutic electrical stimulation (TES) with a motor response (i.e. joint movement is elicited) of the external rotators of the shoulder and extensors of the forearm twice a day for 45 minutes on working days.

The control group receives a (sham) positioning procedure at half the available shoulder range of motion and simultaneous conventional transcutaneous electrical nerve stimulation (TENS) with a sensory response only (i.e. no movement is elicited) of the extensors of the forearm twice a day for 45 minutes on working days.