Functional Electro Stimulation (FES) and occupational therapy in people with sequelae of stroke.

The latest clinical practice guidelines related to stroke recommend the use of functional electrostimulation (such as FES current) as an adjunct to conventional occupational therapy that can improve rehabilitation outcomes and even decrease recovery time, as in the case of upper extremities or gait. A 2018 study conducted in Australia sought to determine the use of FES with stroke survivors by occupational therapists in the state of Victoria and to identify factors influencing the use of this current. Fifty-two percent of therapists surveyed indicated having used FES in the past two years with people with stroke sequelae for upper extremity rehabilitation and functionality in activities of daily living. Another study conducted in South Korea evaluated the effects of mirror therapy in combination with FES and biofeedback on upper extremity motor recovery after stroke. Patients undergoing this therapy showed significant improvement in wrist extension as revealed by manual muscle testing and range of motion, along with significant improvements in the Box and Buckets Test (BBT), Jebsen & Taylor Hand Function Test (JHFT) and Stroke Specific Quality Of Life scale (SS-QOL), suggesting that mirror therapy, in combination with FES and biofeedback, is feasible and effective for upper extremity motor rehabilitation after stroke.

In terms of rehabilitation of reaching and grasping function, FES therapy with upper extremity training has proven to be an effective intervention, as demonstrated in a study conducted in the United States, where patients who underwent such therapy achieved better results than with conventional therapy in terms of object manipulation, palmar grasp, traction and with optimal results in the Barthel index and the Fugl-Meyer upper extremity scale. Biomedical technological advances offer innovations for the optimal rehabilitation of stroke patients, and evidence demonstrates the efficiency of FES therapy with biofeedback as a support to occupational therapy.