Upper limb functional electrical stimulation for walker ambulation in hemiplegia: A case report

Electrical stimulation has been sporadically used in the treatment of hemiplegia. Reported benefits include decreasing spasticity, providing a supplementary means for range of motion exercises, increasing strength, and improving local blood flow in a paretic or paralyzed limb. Some studies have also shown functional gains in the hemiplegic upper limb following treatment with electrical stimulation. Nevertheless, there have been very few reports of the use of neuromuscular stimulation to achieve new hemiplegic upper limb activity not possible without the electrical stimulation. This is a case report of a head injury patient who was able to begin ambulation with a walker, without physical assistance, for the first time in the 16 yr since his injury. A new electrical stimulation device (Handmaster) initially used therapeutically, and then functionally, provided a reliable, strong grasp and release and was instrumental in achieving the new level of function. The device proved to be easy to use in the home, giving the patient microprocessor-controlled therapeutic and patterned functional electrical stimulation.