A Longitudinal Retrospective Study of a Wearable Neuromuscular Electrical Stimulation (NMES) System Shows Significant Improvement of Arm Usage in Hemiparetic and Hemiplegic Patients

Background: Hemiparesis and hemiplegia are commonly observed motor consequences of brain injury and infarction. Brain disorders such as traumatic brain injury (TBI), stroke (cerebrovascular accident, or CVA), and cerebral palsy (CP), as well as surgical interventions, can result in aberrant motor function in the contralateral upper and lower limbs, resulting in paralysis, weakness and/or spasticity in the arm and leg. NMES has been previously used to stimulate affected muscle groups and to increase arm mobility in a variety of brain and spinal cord diseases, yet there remains a paucity of longitudinal evidence examining NMES-mediated improvements in arm usage after brain compromise. Methods In this retrospective cohort study (n = 38), we examined longitudinal (up to 10 years) self-reported arm usage in patients with 1) TBI, 2) stroke, 3) prior hemispherectomy, or 4) cerebral palsy who wore an NMES device, Axiobionics’ BioSleeve, and we compared this to arm usage achieved from years of conventional therapy (physical and occupational therapy) prior to use of the wearable NMES device in this study. Results We found that the patients saw an average increase in arm usage from 9.9–43.5% by the end of the study. This result was well represented across age groups and genders, with varying degrees across different diagnoses. Specifically, the TBI subcohort had a consistent increase in arm usage of 5.5% per year over the term of treatment. Conclusion This study supports the literature identifying NMES as a therapeutic intervention and complements the literature suggesting that NMES application can be used as a long-term method to increase arm usage in hemiplegic patients.