METHOD: Eligible patients with chronic wounds were enrolled between March and June 2016, from the Wound Care Unit, Hospital Kuala Lumpur in this consecutive case series. Standard wound care was performed with microcurrent as an adjunct therapy. Each patient was treated with an anti-inflammatory frequency, followed by a vasodilation frequency, while having their wounds cleansed during each dressing change. Patients were loaned a home-microcurrent device to treat themselves three times daily using a tissue repair frequency for four weeks.

RESULTS: A total of 100 patients with chronic wounds, such as diabetic foot ulcers, venous leg ulcers, and pressure ulcers, were recruited. During the four-week treatment period, all patients had a reduction in wound size, with 16 having complete wound closure. All 89 of the 100 patients who complained of pain, associated with their wound, experienced reduced pain scores, with 11 being pain-free at the end of the four-week period. There was significant reduction (p<0.001) in both mean pain score and mean wound area during the treatment period, as well as improvements in other parameters, such as reduction in inflammatory symptoms (leg swelling, foot stiffness), increased vasodilation (skin discolouration, leg heaviness, early morning erection, sensation), improvement in sleep quality, gait, and frequency of bowel movement. No adverse events were reported.

METHODS: We conducted a comprehensive search of published articles in electronic databases, including PubMed, Scopus, PEDro, Medline (via Ovid), EMBASE, Cochrane Library, and Web of Science, using the following search terms: "stroke"; "upper extremity"; "Constraint-Induced Movement Therapy"; and "Neuromuscular Electrical Stimulation." The search included published studies, conferences, and presentations. The article selection, data extraction, and quality evaluation will be conducted independently by 2 reviewers. The 3rd and 4th reviewers will assist in resolving any disagreements that may arise between the 2 reviewers. The risk of bias in the included studies will be assessed using the PEDro scale and Cochrane risk of bias assessment tool. Narrative synthesis and meta-analysis will be performed based on the characteristics of the included articles, including the risk of bias (if sufficient information is available).

RESULTS: This review summarizes the available evidence and could assist therapists in choosing the best treatment for poststroke upper extremity dysfunction.

CONCLUSION: This study will provide the available evidence on the effectiveness of CIMT and NMES on upper extremity function in patients with stroke.

ETHICS AND DISSEMINATION: Ethical approval is not required because the review will be based on publicly available literature. The findings of this study will be published in a peer-reviewed journal, and updates will be made depending on whether sufficient additional evidence modifies the conclusions of the review. Any changes made to the methods throughout the review will be stated in the article.

Patients and methods: This single-blind, prospective, randomized-controlled study included a total of 20 patients (8 males, 12 females; mean age: 53.5±13.8; range, 31 to 82 years) with chronic neuropathic pain between January 2014 and June 2014. The patients were randomized to BEST (n=10) or placebo (n=10) group. Pain was measured using the Visual Analog Scale, and serum cortisol levels were measured before and after treatment.

Results: There was no significant difference in the baseline demographics, diagnosis, and treatment modalities between the groups. Approximately 50% patients in the treatment group reported that the treatment was effective, compared to 30% in the placebo group. Pain score reduction after treatment in the BEST group was significant (p<0.05), while it was not significant in the placebo group (p=0.4). Cortisol levels significantly reduced only in the BEST group after treatment (p=0.013).