Clinical Research Directory

Surface electrodes will be applied over the motor points of the supraspinatus and deltoid muscles on the paretic side, as well as over the wrist extensors on the dorsal forearm. Electrical stimulation will be delivered using a symmetrical biphasic waveform at a frequency of 30 Hz and a pulse width of 300 μs, with ramp-up and ramp-down times of 1 second each. The current intensity will be adjusted to the patient's maximum tolerance, up to 90 mA. The intervention will be administered for 30 minutes, three times per week, over a period of 6 weeks using the Gymna 400 Series device, with patients positioned in sitting, while participants in Group 2 will not receive electrical stimulation.

Task-specific training (TST) will include six functional tasks based on the motor relearning approach: drinking from a glass, lifting a cup to 90° shoulder flexion, transferring tennis balls, table polishing, moving a cone, and hair combing. Each session will last 60 minutes (10-minute warm-up + 50-minute training). Tasks will be repeated 10-20 times for 1-5 sets or 2-5 minutes, with 2-minute rest breaks every 15 minutes. Tasks will be demonstrated using the non-affected upper limb. Performance will be passive or assisted depending on ability, with gradual progression in speed, distance, and resistance. Verbal, visual, and proprioceptive feedback will be provided to ensure proper execution.

Patients will receive a designed physical therapy program in the form of stretching exercises and strengthening exercises, three times per week for 6 weeks.