EFFECTIVENESS OF PERSONALIZED REHABILITATION, FUNCTIONAL ELECTRICAL STIMULATION, AND COGNITIVE-MOTOR TRAINING ON MOTOR FUNCTION AND COGNITIVE RECOVERY IN STROKE PATIENTS: A RANDOMIZED CONTROLLED TRIAL
Abstract
Background: Stroke frequently produces combined motor and cognitive impairment that limits functional independence. Functional Electrical Stimulation (FES) and Cognitive-Motor Training (CMT) each have supportive evidence, but head-to-head comparison against personalized, patient-tailored rehabilitation is lacking. Objective: To compare the effectiveness of FES, CMT, and personalized rehabilitation on motor function, cognitive recovery, and functional independence after stroke. Methods: In this randomized, single-blind, three-arm controlled trial, 120 patients with ischemic or hemorrhagic stroke (mean age 60.4 ± 8.8 years) were randomized to Group A (FES + conventional rehabilitation, n = 40), Group B (CMT + conventional rehabilitation, n = 40), or Group C (personalized rehabilitation, n = 40) for eight weeks. Outcomes were the Fugl-Meyer Assessment (FMA), Mini-Mental State Examination (MMSE), Functional Independence Measure (FIM), and 6-Minute Walk Test (6MWT), assessed pre- and post-intervention. Paired t-tests evaluated within-group change; one-way ANOVA with Tukey's HSD evaluated between-group differences. Results: All groups improved significantly on every measure (p < .001). Group C achieved the largest gains in FMA (+30.0), FIM (+35.5), and 6MWT (+166.3 m), significantly exceeding Groups A and B (all p < .001; η² = .87–.94). Group B achieved the largest MMSE gain (+5.28), statistically equivalent to Group C (+5.43, p = .75) and significantly greater than Group A (+0.93, p < .001). Group A showed intermediate motor/functional gains, significantly greater than Group B but smaller than Group C on FMA, FIM, and 6MWT (all p < .001). Conclusion: Personalized rehabilitation produced the broadest gains across motor and functional domains, while cognitive-motor training was most effective for cognitive recovery. Individually tailored rehabilitation strategies that match intervention to a patient's impairment profile may outperform uniformly applied single-modality protocols.