Event-Related Desynchronization Induced by Tactile Imagery: an EEG Study.

It is well known that both hand movements and mental representations of movement lead to event-related desynchronization (ERD) of the electroencephalogram (EEG) recorded over the corresponding cortical motor areas. However, the relationship between ERD in somatosensory cortical areas and mental representations of tactile sensations is not well understood. In this study, we employed EEG recordings in healthy humans to compare the effects of real and imagined vibrotactile stimulation of the right hand. Both real and imagined sensations produced contralateral ERD patterns, particularly in the µ-band and most significantly in the C3 region. Building on these results and the previous literature, we discuss the role of tactile imagery as part of the complex body image and the potential for using EEG patterns induced by tactile imagery as control signals in brain-computer interfaces (BCIs). Combining this approach with motor imagery (MI) could improve the performance of BCIs intended for rehabilitation of sensorimotor function after stroke and neural trauma.

Activation of Cerebellum, Basal Ganglia and Thalamus During Observation and Execution of Mouth, hand, and foot Actions.

Humans and monkey studies showed that specific sectors of cerebellum and basal ganglia activate not only during execution but also during observation of hand actions. However, it is unknown whether, and how, these structures are engaged during the observation of actions performed by effectors different from the hand. To address this issue, in the present fMRI study, healthy human participants were required to execute or to observe grasping acts performed with different effectors, namely mouth, hand, and foot. As control, participants executed and observed simple movements performed with the same effectors. The results show that: (1) execution of goal-directed actions elicited somatotopically organized activations not only in the cerebral cortex but also in the cerebellum, basal ganglia, and thalamus; (2) action observation evoked cortical, cerebellar and subcortical activations, lacking a clear somatotopic organization; (3) in the territories displaying shared activations between execution and observation, a rough somatotopy could be revealed in both cortical, cerebellar and subcortical structures. The present study confirms previous findings that action observation, beyond the cerebral cortex, also activates specific sectors of cerebellum and subcortical structures and it shows, for the first time, that these latter are engaged not only during hand actions observation but also during the observation of mouth and foot actions. We suggest that each of the activated structures processes specific aspects of the observed action, such as performing internal simulation (cerebellum) or recruiting/inhibiting the overt execution of the observed action (basal ganglia and sensory-motor thalamus).

Synchronous motor imagery and visual feedback of finger movement elicit the moving rubber hand illusion, at least in illusion-susceptible individuals.

Recent evidence suggests that imagined auditory and visual sensory stimuli can be integrated with real sensory information from a different sensory modality to change the perception of external events via cross-modal multisensory integration mechanisms. Here, we explored whether imagined voluntary movements can integrate visual and proprioceptive cues to change how we perceive our own limbs in space. Participants viewed a robotic hand wearing a glove repetitively moving its right index finger up and down at a frequency of 1 Hz, while they imagined executing the corresponding movements synchronously or asynchronously (kinesthetic-motor imagery); electromyography (EMG) from the participants' right index flexor muscle confirmed that the participants kept their hand relaxed while imagining the movements. The questionnaire results revealed that the synchronously imagined movements elicited illusory ownership and a sense of agency over the moving robotic hand-the moving rubber hand illusion-compared with asynchronously imagined movements; individuals who affirmed experiencing the illusion with real synchronous movement also did so with synchronous imagined movements. The results from a proprioceptive drift task further demonstrated a shift in the perceived location of the participants' real hand toward the robotic hand in the synchronous versus the asynchronous motor imagery condition. These results suggest that kinesthetic motor imagery can be used to replace veridical congruent somatosensory feedback from a moving finger in the moving rubber hand illusion to trigger illusory body ownership and agency, but only if the temporal congruence rule of the illusion is obeyed. This observation extends previous studies on the integration of mental imagery and sensory perception to the case of multisensory bodily awareness, which has potentially important implications for research into embodiment of brain-computer interface controlled robotic prostheses and computer-generated limbs in virtual reality.

Distinct neural representations of hand movement direction between motor imagery and execution in the presupplementary motor area.

Motor simulation theory proposes a functional equivalence between motor execution (ME) and its simulation, suggesting that motor imagery (MI) is the self-intentioned simulation of one's actions. This study used functional magnetic resonance imaging (fMRI) with multivoxel pattern analysis to test whether the direction of hand movement is represented with a similar neural code between ME and MI. In our study, participants used their right hand to move an on-screen cursor in the left-right direction with a joystick or imagined the same movement without execution. The results indicated that the left-right direction as well as their modality (ME or MI) could be decoded significantly above the chance level in the presupplementary motor area (pre-SMA) and primary visual cortex (V1). Next, we used activation patterns of ME as inputs to the decoder to predict hand move directions in MI sessions and found a significantly higher-than-chance accuracy only in V1, not in pre-SMA. Moreover, the representational similarity analysis showed similar activation patterns for the same directions between ME and MI in V1 but not in pre-SMA. This study's finding indicates distinct spatial activation patterns for movement directions between ME and MI in pre-SMA.

Tactile Sensation Assisted Motor Imagery Training for Enhanced BCI Performance: A Randomized Controlled Study.

OBJECTIVE: Independent of conventional neurofeedback training, in this study, we propose a tactile sensation assisted motor imagery training (SA-MI Training) approach to improve the performance of MI-based BCI. METHODS: Twenty-six subjects were recruited and randomly divided into a Training-Group and a Control-Group. All subjects were required to perform three blocks of MI tasks. In the Training-Group, during the second block (SA-MI Training block), tactile stimulation was applied to the left or right wrist while the subjects were performing the left or right-hand MI task, while during the first block (Pre-Training block) and the third block (Post-Training block), subjects performed pure MI tasks without the tactile sensation assistance. In contrast, in the Control-Group, subjects performed the left and right-hand MI tasks in all three blocks. RESULTS: The performance of the Post-Training block (83.2 ± 11.4%) was significantly (p = 0.0014) higher than that of the Pre-Training block (73.2 ± 16.3%). By contrast, in the Control-Group, no significant difference was found among the three blocks. Moreover, after the SA-MI Training, the motor-related cortex activation (i.e., ERD/ERS) and the R 2 coefficient in the alpha-beta band were enhanced, while no training effect was found in the Control-Group. CONCLUSION: The proposed SA-MI Training approach can significantly improve the performance of MI, which provides a novel training framework for MI-based BCI. SIGNIFICANCE: It may be especially beneficial to those who are with difficulty in convention neurofeedback training or performing pure MI mental tasks to gain BCI control.

Vision- and touch-dependent brain correlates of body-related mental processing.

In humans, the nature of sensory input influences body-related mental processing. For instance, behavioral differences (e.g., response time) can be found between mental spatial transformations (e.g., mental rotation) of viewed and touched body parts. It can thus be hypothesized that distinct brain activation patterns are associated with such sensory-dependent body-related mental processing. However, direct evidence that the neural correlates of body-related mental processing can be modulated by the nature of the sensory stimuli is still missing. We thus analyzed event-related functional magnetic resonance imaging (fMRI) data from thirty-one healthy participants performing mental rotation of visually- (images) and haptically-presented (plastic) hands. We also dissociated the neural activity related to rotation or task-related performance using models that either regressed out or included the variance associated with response time. Haptically-mediated mental rotation recruited mostly the sensorimotor brain network. Visually-mediated mental rotation led to parieto-occipital activations. In addition, faster mental rotation was associated with sensorimotor activity, while slower mental rotation was associated with parieto-occipital activations. The fMRI results indicated that changing the type of sensory inputs modulates the neural correlates of body-related mental processing. These findings suggest that distinct sensorimotor brain dynamics can be exploited to execute similar tasks depending on the available sensory input. The present study can contribute to a better evaluation of body-related mental processing in experimental and clinical settings.

Activating effective functional hand movements in individuals with complete tetraplegia through neural stimulation.

Individuals with complete cervical spinal cord injury suffer from a permanent paralysis of upper limbs which prevents them from achieving most of the activities of daily living. We developed a neuroprosthetic solution to restore hand motor function. Electrical stimulation of the radial and median nerves by means of two epineural electrodes enabled functional movements of paralyzed hands. We demonstrated in two participants with complete tetraplegia that selective stimulation of nerve fascicles by means of optimized spreading of the current over the active contacts of the multicontact epineural electrodes induced functional and powerful grasping movements which remained stable over the 28 days of implantation. We also showed that participants were able to trigger the activation of movements of their paralyzed limb using an intuitive interface controlled by voluntary actions and that they were able to perform useful functional movements such as holding a can and drinking through a straw.

ERD modulations during motor imageries relate to users' traits and BCI performances.

Improving user performances is one of the major issues for Motor Imagery (MI) - based BCI control. MI-BCIs exploit the modulation of sensorimotor rhythms (SMR) over the motor and sensorimotor cortices to discriminate several mental states and enable user interaction. Such modulations are known as Event-Related Desynchronization (ERD) and Synchronization (ERS), coming from the mu (7-13 Hz) and beta (15-30 Hz) frequency bands. This kind of BCI opens up promising fields, particularly to control assistive technologies, for sport training or even for post-stroke motor rehabilitation. However, MI - BCIs remain barely used outside laboratories, notably due to their lack of robustness and usability (15 to 30% of users seem unable to gain control of an MI-BCI). One way to increase user performance would be to better understand the relationships between user traits and ERD/ERS modulations underlying BCI performance. Therefore, in this article we analyzed how cerebral motor patterns underlying MI tasks (i.e., ERDs and ERSs) are modulated depending (i) on nature of the task (i.e., right-hand MI and left-hand MI), (ii) the session during which the task was performed (i.e., calibration or user training) and (iii) on the characteristics of the user (e.g., age, gender, manual activity, personality traits) on a large MI-BCI data base of N=75 participants. One of the originality of this study is to combine the investigation of human factors related to the user's traits and the neurophysiological ERD modulations during the MI task. Our study revealed for the first time an association between ERD and self-control from the 16PF5 questionnaire.

Mental rotation of hands and objects in ageing and Parkinson's disease: differentiating motor imagery and visuospatial ability.

Motor imagery supports motor learning and performance and has the potential to be a useful strategy for neurorehabilitation. However, motor imagery ability may be impacted by ageing and neurodegeneration, which could limit its therapeutic effectiveness. Motor imagery can be assessed implicitly using a hand laterality task (HLT), whereby laterality judgements are slower for stimuli corresponding to physically more difficult postures, as indicated by a "biomechanical constraint" effect. Performance is also found to differ between back and palm views of the hand, which may differentially recruit visual and sensorimotor processes. Older adults and individuals with Parkinson's disease (PD) have shown altered performance on the HLT; however, the effects of both ageing and PD on laterality judgements for the different hand views (back and palm) have not been directly examined. The present study compared healthy younger, healthy older, and PD groups on the HLT, an object-based mental rotation task, and an explicit motor imagery measure. The older and PD groups were slower than the younger group on the HLT, particularly when judging laterality from the back view, and exhibited increased biomechanical constraint effects for the palm. While response times were generally similar between older and PD groups, the PD group showed reduced accuracy for the back view. Letter rotation was slower and less accurate only in the PD group, while explicit motor imagery ratings did not differ significantly between groups. These results suggest that motor imagery may be slowed but relatively preserved in both typical ageing and neurodegeneration, while a PD-specific impairment in visuospatial processing may influence task performance. The findings have implications for the use of motor imagery in rehabilitation protocols.

The role of the primary motor cortex in motor imagery: A theta burst stimulation study.

While mentally simulated actions activate similar neural structures to overt movement, the role of the primary motor cortex (PMC) in motor imagery remains disputed. The aim of the study was to use continuous theta burst stimulation (cTBS) to modulate corticospinal activity to investigate the putative role of the PMC in implicit motor imagery in young adults with typical and atypical motor ability. A randomized, double blind, sham-controlled, crossover, offline cTBS protocol was applied to 35 young adults. During three separate sessions, adults with typical and low motor ability (developmental coordination disorder [DCD]), received active cTBS to the PMC and supplementary motor area (SMA), and sham stimulation to either the PMC or SMA. Following stimulation, participants completed measures of motor imagery (i.e., hand rotation task) and visual imagery (i.e., letter number rotation task). Although active cTBS significantly reduced corticospinal excitability in adults with typical motor ability, neither task performance was altered following active cTBS to the PMC or SMA, compared to performance after sham cTBS. These results did not differ across motor status (i.e., typical motor ability and DCD). These findings are not consistent with our hypothesis that the PMC (and SMA) is directly involved in motor imagery. Instead, previous motor cortical activation observed during motor imagery may be an epiphenomenon of other neurophysiological processes and/or activity within brain regions involved in motor imagery. This study highlights the need to consider multi-session theta burst stimulation application and its neural effects when probing the putative role of motor cortices in motor imagery.

Social Touch Somatotopically Affects Mental Body Representations.

In pre-Covid days, many daily actions such as hand shaking or cheek kissing implied physical contact between our body and that of other people. With respect to touching an inanimate object (objectual touch), touching a person (social touch) concerns not only touching a human body, but also that this body belongs to a living person. This fundamental difference also may affect the way we figure our own movements and perceptions or, in other words, how we mentally represent our own body. To test this hypothesis, we asked 30 neurotypical participants to perform mental rotation of images representing hands, full bodies, and feet (an active cognitive task able to activate body representations without need of moving) in two tactile conditions: holding (one in each hand) either the thumbs of another person (social touch) or two plastic cylinders (objectual touch) of about the same circumference and size. Results showed that only mental rotation of hand images was affected by varying the tactile conditions, in that participants were faster during social than objectual touch. This suggests that the nature of hand-related tactile input (social or objectual touch) influences local (hand) and not global (body) mental representations of the body, and in a very somatotopic manner (hands but not feet). We interpret these findings with reference to the differentiation between sensorimotor (body schema) and visuospatial (body image) dynamics in the mental representation of our body. The present study shows that external social factors can affect the internal mental representations of one's own body.

Imagined paralysis reduces motor cortex excitability.

Mental imagery is a powerful capability that engages similar neurophysiological processes that underlie real sensory and motor experiences. Previous studies show that motor cortical excitability can increase during mental imagery of actions. In this study, we focused on possible inhibitory effects of mental imagery on motor functions. We assessed whether imagined arm paralysis modulates motor cortical excitability in healthy participants, as measured by motor evoked potentials (MEPs) of the hand induced by near-threshold transcranial magnetic stimulation (TMS) over the primary motor cortex hand area. We found lower MEP amplitudes during imagined arm paralysis when compared to imagined leg paralysis or baseline stimulation without paralysis imagery. These results show that purely imagined bodily constraints can selectively inhibit basic motor corticospinal functions. The results are discussed in the context of motoric embodiment/disembodiment.

A comparison of directed functional connectivity among fist-related brain activities during movement imagery, movement execution, and movement observation.

Brain-computer interface (BCI) has been widely used in sports training and rehabilitation training. It is primarily based on action simulation, including movement imagery (MI) and movement observation (MO). However, the development of BCI technology is limited due to the challenge of getting an in-depth understanding of brain networks involved in MI, MO, and movement execution (ME). To better understand the brain activity changes and the communications across various brain regions under MO, ME, and MI, this study conducted the fist experiment under MO, ME, and MI. We recorded 64-channel electroencephalography (EEG) from 39 healthy subjects (25 males, 14 females, all right-handed) during fist tasks, obtained intensities and locations of sources using EEG source imaging (ESI), computed source activation modes, and finally investigated the brain networks using spectral Granger causality (GC). The brain regions involved in the three motor conditions are similar, but the degree of participation of each brain region and the network connections among the brain regions are different. MO, ME, and MI did not recruit shared brain connectivity networks. In addition, both source activation modes and brain network connectivity had lateralization advantages.

Electrical stimulation alters muscle morphological properties in denervated upper limb muscles.

BACKGROUND: Damage to lower motor neuron causes denervation and degeneration of the muscles affected. Experimental and clinical studies of muscle denervation in lower extremities demonstrated that direct electrical stimulation (ES) of muscle can prevent denervation atrophy and restore contractility. The aim of this study was to identify possible myogenic effect of ES on denervated forearm and hand muscles in persons with spinal cord injury (SCI) and tetraplegia. METHODS: This prospective interventional study with repeated measurement design included 22 patients aged 48·6 (± 15·7), 0·25 (0·1/46) years after spinal cord lesion, AIS A-D. In each patient, two electrophysiologically-confirmed denervated muscles in the hand and forearm were analyzed - one extrinsic (Extensor Carpi Ulnaris - ECU) and one intrinsic (1st Dorsal Interosseus - IOD1). Muscles were stimulated for 33 min, five times per week over a 12-weeks period. Using ultrasonography (USG), muscle thickness (MT) and pennation angle (PA) of these muscles were determined at start and end of the stimulation period. FINDINGS: MT of IOD1 increased from 6·3 mm (± 3·2 mm) to 9·2 mm (± 2·4 mm) (p = 0·004) and the PA from 5·5° (± 3·0°) to 11° (± 2·2°) (p = 0·001). The corresponding values for the ECU were 5·5 mm (± 2·5 mm) to 7·0 mm (± 2·2 mm) (p = 0·039) and 5·5° (± 3·4°) to 9·4° (± 3·8°) (p = 0·005), respectively. The correlation of MT between baseline and completion was r = 0·58 (p = 0·037) for the ECU and r = 0·63 (p = 0·008) for the IOD1. INTERPRETATION: 12 weeks of direct muscle stimulation increases the MT and PA of the denervated intrinsic and extrinsic hand muscles studied. FUNDING: Swiss Paraplegic Centre, Switzerland.

Testing silicone digit extensions as a way to suppress natural sensation to evaluate supplementary tactile feedback.

Dexterous use of the hands depends critically on sensory feedback, so it is generally agreed that functional supplementary feedback would greatly improve the use of hand prostheses. Much research still focuses on improving non-invasive feedback that could potentially become available to all prosthesis users. However, few studies on supplementary tactile feedback for hand prostheses demonstrated a functional benefit. We suggest that confounding factors impede accurate assessment of feedback, e.g., testing non-amputee participants that inevitably focus intently on learning EMG control, the EMG's susceptibility to noise and delays, and the limited dexterity of hand prostheses. In an attempt to assess the effect of feedback free from these constraints, we used silicone digit extensions to suppress natural tactile feedback from the fingertips and thus used the tactile feedback-deprived human hand as an approximation of an ideal feed-forward tool. Our non-amputee participants wore the extensions and performed a simple pick-and-lift task with known weight, followed by a more difficult pick-and-lift task with changing weight. They then repeated these tasks with one of three kinds of audio feedback. The tests were repeated over three days. We also conducted a similar experiment on a person with severe sensory neuropathy to test the feedback without the extensions. Furthermore, we used a questionnaire based on the NASA Task Load Index to gauge the subjective experience. Unexpectedly, we did not find any meaningful differences between the feedback groups, neither in the objective nor the subjective measurements. It is possible that the digit extensions did not fully suppress sensation, but since the participant with impaired sensation also did not improve with the supplementary feedback, we conclude that the feedback failed to provide relevant grasping information in our experiments. The study highlights the complex interaction between task, feedback variable, feedback delivery, and control, which seemingly rendered even rich, high-bandwidth acoustic feedback redundant, despite substantial sensory impairment.

Influence of the visuo-proprioceptive illusion of movement and motor imagery of the wrist on EEG cortical excitability among healthy participants.

INTRODUCTION: Motor Imagery (MI) is a powerful tool to stimulate sensorimotor brain areas and is currently used in motor rehabilitation after a stroke. The aim of our study was to evaluate whether an illusion of movement induced by visuo-proprioceptive immersion (VPI) including tendon vibration (TV) and Virtual moving hand (VR) combined with MI tasks could be more efficient than VPI alone or MI alone on cortical excitability assessed using Electroencephalography (EEG). METHODS: We recorded EEG signals in 20 healthy participants in 3 different conditions: MI tasks involving their non-dominant wrist (MI condition); VPI condition; and VPI with MI tasks (combined condition). Each condition lasted 3 minutes, and was repeated 3 times in randomized order. Our main judgment criterion was the Event-Related De-synchronization (ERD) threshold in sensori-motor areas in each condition in the brain motor area. RESULTS: The combined condition induced a greater change in the ERD percentage than the MI condition alone, but no significant difference was found between the combined and the VPI condition (p = 0.07) and between the VPI and MI condition (p = 0.20). CONCLUSION: This study demonstrated the interest of using a visuo-proprioceptive immersion with MI rather than MI alone in order to increase excitability in motor areas of the brain. Further studies could test this hypothesis among patients with stroke to provide new perspectives for motor rehabilitation in this population.

Comparison of the Effects of Hugo's Point Massage and Play on IV-Line Placement Pain in Children: A Randomized Clinical Trial.

Reduction of intravenous line placement pain is one of the most important nursing priorities in the pediatric wards. The present study was aimed at comparing the effect of Hugo's point massage and play on the severity of IV-line placement pain in hospitalized children aged 3-6 years in the pediatric ward. 72 children were selected and assigned randomly to three groups, i.e., control, play, and Hugo point massage. In the massage group, the middle angle between the first and second bones of the palm of the opposite hand was massaged, and the playgroup encouraged bubble-making play. The one-way analysis of variance (ANOVA) did not show a statistically significant difference between the mean IV-line placement pain in play, Hugo's point, and control groups before interventions (p=0.838; p > 0.05). However, the ANOVA test revealed a significant difference between the mean IV-line placement pain in play, Hugo's point, and control groups after the interventions (p=0.006; p < 0.05). The result of the post hoc Scheffe test also showed a statistically significant difference between the mean intensity of IV-line placement pain in both play therapy and Hugo's point massage groups (p=0.028; p < 0.05). Moreover, this test showed that the playgroup children felt less pain than Hugo's point and control group children. This study showed that, in comparison with Hugo's point massage, the play was a more effective way for reducing pain caused by IV-line placement in children, and pediatric nurses can play a significant role in reducing and managing children's pain by using it.

Implicit motor imagery using laterality recognition in functional movement disorders.

Functional movement disorder (FMD) presents as disabling motor symptoms that cannot be explained by organic processes. Despite the lack of lesion or known central nervous system dysfunction, distortion in sensorimotor processing in movement generation and execution is often observed. A person's capacity to judge laterality of a body part requires processing of sensorimotor information. This prospective observational study compared reaction time (RT) and accuracy (ACC) of hand laterality recognition between 30 people diagnosed with FMD and 30 age-matched healthy control participants. The association of RT and ACC with severity of FMD as measured by the Simplified Functional Movement Disorders Rating Scale (SFMDRS) was also explored. RT was on average 0.6 s slower (95% CI 0.4 - 0.8 s, p < 0.001) in patients with FMD (mean 2.2 s, standard deviation (SD) 0.5) than controls (mean 1.7 s, SD 0.3). ACC was on average 8.9% lower (95% CI -15.7 - -2.2, p = 0.01) in patients with FMD (mean 79.6%, SD 16.6) than controls (mean 88.5%, SD 8.1). When adjusted for SFMDRS using robust regression, RT was 0.3 s slower (95% CI 0.01 - 0.5, p = 0.04) in cases than in controls, but ACC was no longer different between groups. There was a moderate negative correlation between RT and ACC in FMD patients (ρ -0.58, p < 0.001 but not in controls (ρ -0.26, p = 0.17). People with FMD had significantly slower RT and lower ACC compared to the control group. These results provide new insights into underlying sensorimotor processing deficits in those with FMD.

Mental rotation performance in young adults with and without developmental coordination disorder.

While there have been consistent behavioural reports of atypical hand rotation task (HRT) performance in adults with developmental coordination disorder (DCD), this study aimed to clarify whether this deficit could be attributed to specific difficulties in motor imagery (MI), as opposed to broad deficits in general mental rotation. Participants were 57 young adults aged 18-30 years with (n = 22) and without DCD (n = 35). Participants were compared on the HRT, a measure of MI, and the letter number rotation task (LNRT), a common visual imagery task. Only participants whose behavioural performance on the HRT suggested use of a MI strategy were included in group comparisons. Young adults with DCD were significantly less efficient compared to controls when completing the HRT yet showed comparable performance on the LNRT relative to adults with typical motor ability. Our data are consistent with the view that atypical HRT performance in adults with DCD is likely to be attributed to specific difficulties engaging in MI, as opposed to deficits in general mental rotation. Based on the theory that MI provides insight into the integrity of internal action representations, these findings offer further support for the internal modelling deficit hypothesis of DCD.

A randomised clinical trial comparing 35 Hz versus 50 Hz frequency stimulation effects on hand motor recovery in older adults after stroke.

More solid data are needed regarding the application of neuromuscular electrical stimulation (NMES) in the paretic hand following a stroke. A randomised clinical trial was conducted to compare the effects of two NMES protocols with different stimulation frequencies on upper limb motor impairment and function in older adults with spastic hemiparesis after stroke. Sixty nine outpatients were randomly assigned to the control group or the experimental groups (NMES with 50 Hz or 35 Hz). Outcome measures included motor impairment tests and functional assessment. They were collected at baseline, after 4 and 8 weeks of treatment, and after a follow-up period. NMES groups showed significant changes (p < 0.05) with different effect sizes in range of motion, grip and pinch strength, the Modified Ashworth Scale, and the muscle electrical activity in the extensors of the wrist. The 35 Hz NMES intervention showed a significant effect on Barthel Index. Additionally, there were no significant differences between the groups in the Box and Block Test. Both NMES protocols proved evidence of improvements in measurements related to hand motor recovery in older adults following a stroke, nevertheless, these findings showed that the specific stimulation frequency had different effects depending on the clinical measures under study.