Functional Electrical Stimulation for home use in patients after stroke

Aim: The aim of this pragmatic observational study was to identify for which purposes Functional electrical stimulation (FES) has been prescribed in University Rehabilitation Institute of Republic of Slovenia – Soča (URI-Soča) for long term treatment at home and whether prescribing practice has been changed over time in the last 10 years. Methods: A pragmatic cohort retrospective study included 373 stroke patients that performed inpatient rehabilitation at the Department for rehabilitation of patients after stroke URI-Soča between January 2010 and December 2019, and used FES at home after discharge. Results: FES was most often prescribed to patients with mild disability and severely affected upper extremity after stroke. Half of the patients used FES on the paretic upper extremity, 46.9% on the hemiparetic upper and lower extremity and only minority (2.9%) on the affected lower extremity alone. The upper limb stimulation predominated almost in the whole observational period. 22.3% of the patients used FES for more than 1 year, on average 3.5 years. A combination of FES and botulinum toxin therapies was used as a spasticity treatment of affected upper extremity in almost one third of patients (29.8%). In a group that used FES for more than one year, botulinum toxin therapies were statistically significantly more frequent (P<0.001). Conclusions: Almost one-third of patients included in this study got FES for home use to manage spasticity. More than a half of those who used FES at home for years used combination of botulinum toxin and FES therapies which suggests they felt effectiveness of combined treatment approach.