Efficacy of Sensory Electrical Stimulation Versus Alternating Electromyography (EMG) on the Functional Recovery of the Hand in Chronic Stroke Survivors: Randomized Controlled Trial

Background and purpose: Upper limb paresis among stroke survivors is the most common physical disability, significantly affecting their ability to perform Activities of Daily Living (ADL). Electrical stimulation is considered a promising approach to restore upper limb function. This study aimed to compare the effectiveness of Sensory Electrical Stimulation (SES) and alternating Electromyogram (EMG) Biofeedback in improving hand function in chronic stroke patients. Materials and Method: Sixty stroke participants were randomly divided into three groups: experimental group 1 received standard physical therapy plus SES; experimental group 2 received physical therapy with alternating EMG Biofeedback; and the control group received only standard physical therapy. Over a three-month period, hand function was evaluated using the Action Research Arm Test (ARAT), muscle strength was assessed via the Medical Research Council (MRC) Scale, and spasticity was measured using the Modified Ashworth Scale. Results: Statistical analysis showed significant improvements in motor function, muscle strength, and reduced spasticity in both experimental groups compared to the control group (p < 0.05). Notably, experimental group 2 (EMG Biofeedback) showed superior outcomes in ARAT subscales—grasp (89.74%), grip (97.62%), and pinch (69.08%)—and exhibited lower wrist spasticity (p = 0.014) than experimental group 1 (SES). Conclusion: The findings suggest that both SES and EMG Biofeedback are effective when integrated into structured hand-training programs for chronic stroke rehabilitation. However, alternating EMG Biofeedback showed greater efficacy in improving hand function, increasing muscular strength, and reducing spasticity, making it a more favorable intervention for this patient population. Trial registration: Registered at ClinicalTrials.gov on 20 ^th February 2025 (ClinicalTrials.gov identifier: NCT06836596).