Efficacy of Percutaneous Electrical Nerve Stimulation: Spasticity Management and Motor Recovery in Stroke Rehabilitation – A Randomized Controlled Trial

sanjivani Kamble, Tushar Palekar
Purpose:

The main aim of the study was to evaluate the effectiveness of PENS in reducing wrist flexor spasticity and enhancing upper-limb motor function in stroke survivors. Secondary objectives included comparing the pre-, post-, and follow-up outcomes of spasticity reduction and motor function improvements between the experimental group receiving PENS and the control group receiving only conventional treatment

Methods:

A total of 80 stroke individuals were randomly assigned to two groups using the coin toss method. Group A (Experimental Group) received PENS plus conventional therapy, while Group B (Control Group) received only conventional therapy. In Group A, needles were inserted into the flexor carpi radialis and ulnaris muscles on the affected side, with three PENS treatment sessions of 15 minutes each, spaced 48 hours apart. Outcome measures included the Modified Ashworth Scale (MMAS), H-reflex amplitude, Modified Tardieu Scale (MTS), and the Wolf Motor Function Test (WMFT). Assessments were conducted at baseline, post-intervention, and during follow-up.

Results:

Intra-group analysis revealed statistically significant improvements in Group A for the H-reflex amplitude (p 0.0001) and MTS pre- and post-treatment (p = 0.001), with no significant difference between post-intervention and follow-up. Group A also showed notable improvement in WMFT and MMAS scores pre- and post-intervention (p = 0.0001), indicating reduced spasticity and better motor function. Similar to the H-reflex and MTS, there was no significant difference between post-treatment and follow-up measures in Group A.

Conclusion(s):

The study demonstrates that PENS is an effective therapeutic intervention for reducing wrist flexor spasticity and improving motor function in stroke survivors. These results suggest that incorporating PENS into conventional treatment protocols can enhance rehabilitation outcomes. However, further research is needed to explore long-term effects and to confirm these findings in larger populations.

Implications:

The successful use of PENS in reducing spasticity and improving motor function in stroke patients holds promise for its broader application in clinical physiotherapy practice. Incorporating PENS into rehabilitation programs could significantly improve functional outcomes for stroke survivors. For practitioners, training in PENS techniques may enhance their ability to treat spasticity more effectively. In terms of policy, integrating PENS into stroke rehabilitation protocols may be recommended to optimize patient recovery outcomes.

Funding acknowledgements:
Nil
Keywords:
stroke
PENS
Spasticity
Primary topic:
Neurology: stroke
Second topic:
Disability and rehabilitation
Third topic:
Health promotion and wellbeing/healthy ageing/physical activity
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
Dr. D. Y. Patil College of Physiotherapy, Dr. D. Y. Patil Vidyapeeth, Pune, India, pune, India
Provide the ethics approval number:
DYPCPT/IEC/09/2022
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
No

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