Comparison of four evaluation approaches in transcutaneous electrical nerve stimulation treatment in two incomplete tetraplegic subjects

Neuromodulation. 2010 Jul;13(3):238-45. doi: 10.1111/j.1525-1403.2009.00266.x. Epub 2010 Jan 12.

Abstract

Introduction: In the present investigation, we applied the whole-hand transcutaneous electrical nerve stimulation (TENS) therapy to two incomplete tetraplegic subjects and assessed their progress with four evaluation methods.

Methods: Two spinal cord injured subjects with spastic upper extremities participated in the study. The TENS therapy was added to their regular treatment. The TENS was delivered to the subject's hands by a conductive glove. The therapy consisted of 20-min sessions each working day during a period of four weeks. The used assessment methods were: maximal force test, force tracking task, Jebsen-Taylor hand function test, and modified Ashworth scale.

Results: The results show increased finger muscle strength, improved motor control and hand function in both patients. The reduction of muscle tone, as assessed by the modified Ashworth scale, was observed in one subject.

Discussion: There was no correlation found between the Jebsen-Taylor test and the maximal force test or force tracking task in this investigation. Assessment methods are complementary to each other as each one adds new or more detailed information about level of impairment.

Conclusion: From the comparison of four evaluation methods, it is evident that different assessments and measurements should be used in order to get better picture of patient's upper extremity impairment.