A home program of sensory and neuromuscular electrical stimulation with upper-limb task practice in a patient 5 years after a stroke

Background and Purpose. This case report describes a person with upper-extremity (UE) hemiparesis who participated in a home program that included sensory amplitude electrical stimulation (SES) to his involved arm and performance of task-specific exercises with the assistance of neuromuscular electrical stimulation (NMES). Case Description. The patient was a 67-year-old man with stable sensory and motor deficits 5 years after a stroke. Sensory amplitude electrical stimulation was delivered for 2 hours per day. A daily, 15-minute course of NMES was used to help him perform UE tasks. This home program was carried out for 18 weeks and included 6 physical therapist home visits. Outcomes. The patient's UE score on the Stroke Rehabilitation Assessment of Movement (STREAM) improved from 10/20 to 17/20. The score on the Action Research Arm Test (ARAT) improved from 27/57 to 42/57. The patient reported that he was now able to button buttons, use a knife and fork, and tie simple fishing knots. Discussion. A home program combining SES and NMES may be an effective method to increase UE function even 5 years after a stroke.