Effects of Functional Electrical Stimulation on Pain and Shoulder Subluxation in Hemiplegic Patients: A Randomised Clinical Trial
DOI:
https://doi.org/10.55735/p5x5xh98Keywords:
Functional electrical stimulation , Hemiplegia , Shoulder subluxationAbstract
Background: Shoulder pain is common in hemiplegic stroke patients, frequently reported across studies. It is a disabling symptom requiring continuous management alongside stroke rehabilitation. If untreated, it may lead to prolonged capsular stretch, irreversible damage, and shoulder subluxation, significantly affecting recovery and functional independence in the long term. Objective: To determine the effects of functional electrical stimulation on pain intensity, shoulder subluxation, and upper extremity motor function in hemiplegic patients. Methodology: A clinical trial was conducted at Nishtar Hospital, Multan, over nine months, with 60 patients selected via purposive sampling. Participants were divided into an experimental group receiving functional electrical stimulation and a control group with conventional therapy. Participants admitted no later than four months post-stroke with hemorrhagic or thromboembolic cerebrovascular disease, presenting with Brunnstrom stages 1 to 4, and the ability to comprehend study procedures, both genders were included. Exclusion criteria were unconscious patients, those with recurrent stroke, bilateral hemiplegia, neurological deficits, or epilepsy. Assessments at baseline, 3rd, and 6th weeks used t-test, repeated measures ANOVA, and Mann-Whitney U tests to evaluate functional independence, pain, motor function, ability, and subluxation outcomes. Results: The functional electrical stimulation group showed a significant difference at the 3rd and 6th week assessment with p-values of 0.012 and 0.041, respectively, for the functional independence measure. Pain score was also improved significantly at the 3rd and 6th week with p-values of 0.000 and 0.021, respectively. Motor function was equally improved up to the 3rd week with a p-value of 0.713 and significantly improved at final measurement with a p-value of 0.000. The Mann-Whitney U Test for functional ability scale showed significant improvement at both post-operative levels (p=0.000). At the same time, subluxation outcomes were equal at final measurement, which was important at the 3rd week. (p=0.367 and 0.001). Conclusion: There were significant effects of functional electrical stimulation in reducing pain, increasing function, and short-term management of shoulder subluxation. In the long term, conventional therapy showed marked but equal improvement.
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