Effect of NMES on Spasticity

Inclusion Criteria: * Age between 18 and 70 years * Post-stroke wrist flexor spasticity scored as Grade 2 or 3 on the Australian Spasticity Assessment Scale (ASAS), specifically selecting patients whose passive stretch resistance (post-catch response) can be easily overcome to ensure accurate and unconfounded electrophysiological evaluation. * Provision of voluntary, written informed consent prior to study enrollment. Exclusion Criteria: * Age \<18 or \>70 year * Contraindications to neuromuscular electrical stimulation (e.g., active electronic implants, history of epilepsy, or localized skin lesions preventing electrode placement) * Concomitant wrist contracture or pain sufficient to impede clinical evaluation * Structural abnormalities of the elbow joint obstructing median nerve stimulation * Median nerve neuropathy or injury in the ipsilateral upper extremity. * Non-stable dosage of antispastic medications within the 2 weeks prior to baseline * Initiation of medications affecting nerve conduction (e.g., antidepressants, anticonvulsants, anesthetics) within the past month; patients on a stable dose for \>1 month remain eligible * Botulinum toxin infiltration in the target spastic muscles within the preceding 3 months * History of neurolytic procedures targeting spasticity in the affected limb. * History of orthopedic or neurological surgery targeting spasticity in the affected limb * Cognitive impairment severe enough to compromise adherence to study protocols * Inabilit…