Flexion synergy in the stroke patient makes voluntary elbow extension difficult or impossible. Activation of the triceps with electrical stimulation when a flexion synergy is present can be a means of generating latent elbow extension, inhibiting biceps spasticity & reducing the possibility of en elbow flexion contracture.
Although symmetric biphasic waveform may be most comfortable for triceps stimulation overflow into the brachioradialis muscle may occur. To reduce undesirable overflow into the elbow flexors asymmetric waveform may be required with discrete electrode placement where the negative pole (cathode) is slightly smaller (1″ x 2″) than the positive pole (anode, 1.5″ x 2″).
Stimulation in standing & practice of weight bearing on the affected limb using a footswitch to trigger stimulation will further assist in achieving the clinical goal of full elbow extension & preservation of elbow range of motion in the stroke patient.
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