Quick Overview

A 2023 peer-reviewed pilot study tested whether EMS — electrical stimulation — may ease tight biceps after chronic MCA stroke. R. Shaik, K. R. Jyothi, and Prof. Dr. P. Sasikala, M.D., enrolled 11 adults aged 40–60. Five had triceps motor-point EMS. Six had biceps tendon-junction EMS. Both groups did 30 contractions, five days a week, for four weeks.

Scientists measured H-reflex, F/M ratio, and stretch VAS. Both methods improved. Junction EMS led: H-reflex 24.59 to 32.05, F/M ratio 8.46 to 4.99, VAS 8.77 to 5.77 (p < 0.0001).

Those numbers suggest structured EMS may help some stroke arms feel less tight and less painful to stretch. The paper is public and indexed. Read the full post for settings, tables, and limits.

We always provide direct links to the original research at the end of every article so you can review the evidence yourself.

Stroke Pilot Study Links EMS To A 34% Drop In Stretch Pain

A tight arm after stroke can turn a simple reach into a fight. Clothes snag. Sleep breaks. Stretching hurts.

In 2023, a small pilot study asked whether targeted EMS — electrical stimulation of muscle — could ease that biceps tightness. The team did not guess. They measured nerves, muscle responses, and stretch pain before and after four weeks.

This article reports that published paper. It is not medical advice. It does not advertise a device. Talk with a qualified clinician before any treatment.

Who Published The Study

The paper ran in the International Journal of Physiotherapy on 9 September 2023. Volume 10, issue 3, pages 87 to 90. The DOI is 10.15621/ijphy/2023/v10i3/1417.

That journal is peer-reviewed. Independent reviewers read a paper before it goes public. It has been open access since 2014. Anyone can read the full text.

The print ISSN is 2349-5987. The online ISSN is 2348-8336. Each article gets a Crossref DOI, so the record is stable and citable.

Why the publisher is a fair source to cite, without dressing it up as a top global medical weekly:

• It is indexed in Web of Science through Clarivate’s Emerging Sources Citation Index.
• It is listed in the Directory of Open Access Journals.
• Articles are archived with Portico, so the file is meant to stay available.
• The journal checks manuscripts for plagiarism and uses peer review.
• It publishes physiotherapy and rehabilitation research, which matches this topic.

That mix is how readers can check the paper themselves. The study is public. The methods are written down. The numbers are in a table.

Who Did The Research

Three named authors signed the work.

Prof. R. Shaik is the corresponding author. Public academic profiles list him as Principal of GEMS College of Physiotherapy in Ragolu, Srikakulam, and as Professor there. His listed qualification is a Master of Physiotherapy. This paper formed part of PhD work registered with Dr. NTR University of Health Sciences, Vijayawada. That university is a state health-sciences university that affiliates physiotherapy and medical colleges. GEMS College of Physiotherapy is one of those affiliated colleges.

K. R. Jyothi is listed from the same physiotherapy college. She is a named co-author on the methods and the four-week results.

Prof. Dr. P. Sasikala, M.D., is the medical-college professor on the team. The paper names her as Professor in the Department of Physiology at Narayana Medical College, Nellore. College staff lists name Dr. P. Sasikala as Professor and Head of Physiology. She holds an M.D. in Physiology and a state medical registration. Physiology is the science of how nerves and muscles work. That is the field behind H-reflex and F/M ratio testing.

So the byline is not a random blog trio. It is a physiotherapy principal running doctoral work, a college co-author, and a medical-college physiology professor. Ethics clearance was obtained. The authors also note a Clinical Trials Registry of India link for the wider project.

What They Wanted To Know

Spasticity is that stiff, springy tightness after stroke. In the arm it often hits the biceps. Older electrical stimulation work often targeted the opposite muscle, the triceps. Newer ideas point at the tight muscle’s tendon end, where Golgi tendon organs sit.

The team compared both ideas in chronic MCA stroke.

Who Took Part

Eleven adults aged 40 to 60 joined. Each had a first MCA stroke at least six months earlier. Each still had biceps spasticity graded 1+ to 2. Touch and pain sensation were intact.

People with pacemakers, heart failure, epilepsy, broken skin, or metal in the affected arm were excluded.

Five people received antagonist EMS on triceps. Six received agonist EMS on the biceps musculotendinous junction. Both groups kept the same usual rehab. Only the stimulation site changed.

What The EMS Sessions Looked Like

Sessions ran five days a week for four weeks. Each session aimed for 30 visible contractions.

The triceps group sat with a semi-flexed elbow. Stimulation sat on the motor point. Frequency ranged from 40 Hz to 100 Hz. Pulse width was 0.7 ms.

The biceps group sat with the arm supported. Diagnostic ultrasound first marked the musculotendinous junction. Stimulation sat there. Frequency ranged from 40 Hz to 70 Hz. Pulse width was 0.7 ms. Intensity could reach 50 mA or more, within comfort.

What They Measured

They recorded the H-reflex and the F/M ratio in the tight biceps. Those are electrodiagnostic readings of reflex and motor-neuron excitability. They also scored stretch pain on a VAS from 0 to 10.

Tests ran on day one and after four weeks.

What The Numbers Showed

Both EMS methods moved in the same helpful direction.

In the triceps group, mean H-reflex rose from 24.95 to 29.09. Mean F/M ratio fell from 8.40 to 6.23. Mean stretch VAS fell from 8.7 to 6.0.

In the biceps junction group, mean H-reflex rose from 24.59 to 32.05. Mean F/M ratio fell from 8.46 to 4.99. Mean stretch VAS fell from 8.77 to 5.77.

Within each group the authors reported p values under 0.0001 for those three measures. After four weeks the junction group showed larger measured change. Between-group p values were under 0.0001 for H-reflex and F/M ratio. Stretch pain favoured the junction group at p = 0.0002.

The authors gave a mean gap of 2.965 ms for H-reflex and 1.235 for F/M ratio. They read those shifts as less reflex over-excitement and less stretch pain.

The Brighter Finding In This Small Sample

Both regular EMS schedules sat beside better lab readings and lower stretch pain. The biceps tendon-junction method led on those scores. Thirty contractions, five days a week, for four weeks, sat behind every post-test number.

The authors argue that stimulating the tight muscle at the tendon end may switch on a calming pathway inside the same muscle. In this sample, that method showed the larger measured lift.

Keep The Scale Honest

This was a pilot study of 11 people. There was no large sham-stimulation arm. The authors did not use a bedside spasticity scale as the main outcome. They said four weeks may be too short for those clinic tests to match the nerve numbers. Results apply to chronic MCA stroke with mild-to-moderate biceps tightness, not every stroke or every joint.

What This Can Fairly Tell A Reader

The paper does not prove that a home gadget will fix stroke. It does add measured signals from named college and medical-college authors in a peer-reviewed journal. In these 11 people, structured EMS sat beside quieter biceps tests and less stretch pain. The tendon-junction method led on those scores.

If EMS is being considered after stroke, that choice belongs with a physiotherapist or doctor who knows the person.

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Research Summary

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