title: Effects of somatosensory stimulation on motor function after subacute stroke.
abstract: BACKGROUND
  Previous works showed potentially beneficial effects of a single session of peripheral nerve sensory stimulation (PSS) on motor function of a paretic hand in patients with subacute and chronic stroke.
  
  
  OBJECTIVE
  To investigate the influence of the use of different stimulus intensities over multiple sessions (repetitive PSS [RPSS]) paired with motor training.
  
  
  METHODS
  To address this question, 22 patients were randomized within the second month after a single hemispheric stroke in a parallel design to application of 2-hour RPSS at 1 of 2 stimulus intensities immediately preceding motor training, 3 times a week, for 1 month. Jebsen-Taylor test (JTT, primary endpoint measure), pinch force, Functional Independence Measure (FIM), and corticomotor excitability to transcranial magnetic stimulation were measured before and after the end of the treatment month. JTT, FIM scores, and pinch force were reevaluated 2 to 3 months after the end of the treatment.
  
  
  RESULTS
  Baseline motor function tests were comparable across the 2 RPSS intensity groups. JTT improved significantly in the lower intensity RPSS group but not in the higher intensity RPSS group at month 1. This difference between the 2 groups reduced by months 2 to 3.
  
  
  CONCLUSIONS
  These results indicate that multiple sessions of RPSS could facilitate training effects on motor function after subacute stroke depending on the intensity of stimulation. It is proposed that careful dose-response studies are needed to optimize parameters of RPSS stimulation before designing costly, larger, double-blind, multicenter clinical trials.
authors.affiliation: Hospital das Clínicas/São Paulo University, São Paulo, Brazil, Instituto Israelita de Ensino e Pesquisa Albert Einstein, São Paulo, Brazil. abconf@yahoo.com
authors.forename: Adriana Bastos
authors.initials: AB
authors.lastname: Conforto
authors.forename: Karina Nocelo
authors.initials: KN
authors.lastname: Ferreiro
authors.forename: Camilla
authors.initials: C
authors.lastname: Tomasi
authors.forename: Renata Laurenti
authors.initials: RL
authors.lastname: dos Santos
authors.forename: Viviane Loureiro
authors.initials: VL
authors.lastname: Moreira
authors.forename: Suely Kazue Nagahashi
authors.initials: SK
authors.lastname: Marie
authors.forename: Silvia Cristina
authors.initials: SC
authors.lastname: Baltieri
authors.forename: Milberto
authors.initials: M
authors.lastname: Scaff
authors.forename: Leonardo G
authors.initials: LG
authors.lastname: Cohen
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D005260:Female; D007839:Functional Laterality; D006225:Hand / Q000503:physiopathology; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000503:physiopathology; D008875:Middle Aged; D009043:Motor Activity; D018482:Muscle, Skeletal / Q000294:innervation / Q000503:physiopathology*; D010291:Paresis / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D020127:Recovery of Function; D013003:Somatosensory Cortex / Q000503:physiopathology*; D020521:Stroke / Q000150:complications / Q000503:physiopathology*; D000071939:Stroke Rehabilitation; D050781:Transcranial Magnetic Stimulation; D004561:Transcutaneous Electric Nerve Stimulation / Q000379:methods; D016896:Treatment Outcome