Effect of transcutaneous electrical nerve stimulation applied to acupuncture points on gait and quality of life in stroke patients

Abstract

Background. Post-stroke spasticity is a disabling impairment that negatively impacts walking performance and quality of life (QoL). It has been established that non-intrusive techniques like transcutaneous electrical nerve stimulation (TENS) have anti-spastic characteristics. Purpose. To identify the additional effect of TENS applied to acupuncture points on spasticity, walking performance and QoL in chronic stroke patients. Methods. A randomized controlled trial was carried out on thirty stroke patients from both sexes aged 45-60 years. They were randomly allocated into the study and the control groups, with 15 patients in each group. Patients in the control group underwent a designed physiotherapy program, while participants in the study group underwent the same physiotherapy program plus TENS on acupoints of the affected lower extremity. The measured variables comprised the Modified Ashworth Scale (MAS) for evaluating spasticity, the World Health Organization quality of life assessment instrument (WHOQOL-BREF) for evaluating QoL and the Biodex Gait Trainer for measuring the spatiotemporal gait parameters. Evaluation of all variables took place before and following intervention. Results. There was a statistically significant improvement of all measured variables in both groups post-treatment (p < 0.05) except for the MAS score for the control group which was non-significant (p = 0.65). There was a significant decrease in MAS score (p = 0.03) and a significant increase in walking speed, step length of the affected and non-affected sides, time of single limb support on affected leg and the WHOQOL-BREF scores of study group compared with that of control group post-treatment (p < 0.05). Conclusion. Transcutaneous electrical nerve stimulation (TENS) applied to acupoints could be an effective, safe, and cost-wise adjunct to a physiotherapy program in improving spasticity, walking performance and QoL in chronic stroke survivors.