Turkish Journal of Physical Medicine and Rehabilitation 2011 , Vol 57 , Num 2

Effect of Electrical Stimulation Combined with Electromyographic Biofeedback and Exercise Practices on Upper Extremity Rehabilitation after Stroke

Yavuz Selim Pehlivan 1 ,Onur Armağan 2
1 Eskiflehir Yunus Emre Devlet Hastanesi, Fizik Tedavi ve Rehabilitasyon Kliniği, Eskiflehir, Türkiye
2 Eskiflehir Osmangazi Üniversitesi Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Eskiflehir, Türkiye
DOI : 10.4274/tftr.57.14

Objective: In this study, we aimed to investigate the additional benefits of ES (electrical stimulation) combined with EMG-BF (electromyographic biofeedback) on motor and functional outcomes in 30 patients admitted to Eskiflehir Osmangazi University Faculty of Medicine, Department of Physical Medicine and Rehabilitation.


Metarials and Methods: Medicine and Rehabilitation, with hemiparetic upper extremity after stroke. The patients were divided into three groups. Group 1 was assigned to exercise and ES, group 2 - to exercise, EMG-BF and ES, and group 3 – to exercise alone. All procedures were administered for one hour a day, 5 days in a week, for 4 weeks. The Barthel Index (BI), Upper Extremity Function Test, Brunnstrom stages of motor recovery for hands, goniometric measurement of active wrist extension and the Motricity Index (MI) were used to assess the efficiency of treatment.


Results: There were statistically significant improvements in Brunnstrom stages of motor recovery for hand (p<0.05), goniometric measurement of active wrist extension (p<0.05), upper extremity function test (p<0.01), BI (group 1 p<0.05, group 2 p<0.01) and MI (group 1 p<0.05, group 2 p<0.01) for both first and second groups after treatment. In group 3, significant improvement was found only in MI. Advanced significant improvement in surface EMG activity was observed only in group 2 (p<0.01).


Conclusion: Although our results do not support the efficacy of combined therapy, considering the mechanisms of effects of ES and EMG-BF, it can be suggested that ES and EMG-BF are complementary procedures. We think that further studies are needed on this issue. 

Keywords : Stroke, hemiplegia, electromyographic biofeedback, electrical stimulatio