EFFECT OF NEUROMUSCULAR ELECTRICAL STIMULATION ON LOWER LIMB STRENGTH IN POST-STROKE HEMIPLEGIC PATIENTS: A RANDOMIZED CONTROLLED TRIAL

Authors

DOI:

https://doi.org/10.71000/4s1bmc62

Keywords:

Electric Stimulation Therapy; Hemiplegia; Lower Extremity; Muscle Strength; Rehabilitation; Stroke; Walking Speed

Abstract

Background: Lower limb weakness following stroke remains a major barrier to functional independence, with many patients experiencing limited voluntary muscle activation during early recovery. Neuromuscular electrical stimulation has been proposed as a potential adjunct to enhance muscle strength and facilitate motor relearning, yet evidence remains variable across clinical contexts.

Objective: To evaluate the effectiveness of neuromuscular electrical stimulation in improving lower limb strength, motor recovery, and functional mobility among post-stroke hemiplegic patients.

Methods: A randomized controlled trial was conducted involving 60 participants with unilateral lower limb hemiplegia. Patients were randomly allocated into an intervention group receiving neuromuscular electrical stimulation in addition to routine physiotherapy, or a control group receiving physiotherapy alone, over a six-week period. Lower limb muscle strength was assessed using a handheld dynamometer, motor performance using the Fugl–Meyer Lower Extremity scale, and functional mobility through the Timed Up and Go test. Data were analyzed using paired and independent t-tests, with significance set at p<0.05.

Results: Participants receiving electrical stimulation showed substantial gains in quadriceps, hamstring, and dorsiflexor strength compared with controls. Quadriceps strength increased from 12.1 kg to 18.4 kg in the intervention group versus 12.3 kg to 14.2 kg in the control group. The intervention group also demonstrated greater improvement in Fugl–Meyer scores (18.6 to 27.9) compared to controls (18.1 to 22.4). Timed Up and Go performance improved more prominently in the intervention group, reducing from 28.4 to 19.1 seconds, whereas the control group improved from 28.7 to 24.8 seconds.

Conclusion: Neuromuscular electrical stimulation provided significant enhancement of lower limb strength and motor performance when added to conventional rehabilitation in post-stroke hemiplegic patients. These findings support its integration as an effective adjunct for early lower limb recovery.

Author Biographies

  • Abdul Wahab, Rizwan Medical Center – Department of Rehabilitation and Neuro-Diagnostics), Peshawar, KPK, Pakistan.

    Clinical Neuro Physical Therapist, RMC (Rizwan Medical Center – Department of Rehabilitation and Neuro-Diagnostics), Peshawar, KPK, Pakistan.

  • Waqas Ahmed, Ziauddin Hospital, Karachi, Pakistan.

    Senior Physiotherapist, Ziauddin Hospital, Karachi, Pakistan.

  • Sannia Batool, Margalla Institute of Health Sciences, Rawalpindi, Pakistan.

    Master of Science in NeuroMuscular Physical Therapy, Senior Lecturer, Margalla Institute of Health Sciences, Rawalpindi, Pakistan.

  • Fareeha F Khan, The Kidney Center Hospital, Pakistan.

    Senior Medical Officer (ICU), The Kidney Center Hospital, Pakistan.

  • Naeem Hussain, Isra University, Hyderabad, Pakistan.

    MBBS Student, Isra University, Hyderabad, Pakistan.

  • Emaan Rehmat, Bloomfield Hall School, Sahiwal, Pakistan.

    Bloomfield Hall School, Sahiwal, Pakistan.

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Published

2025-12-15