Effects of somatosensory stimulation on motor function after subacute stroke.
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.
Conforto
Adriana Bastos
AB
Hospital das Clínicas/São Paulo University, São Paulo, Brazil, Instituto Israelita de Ensino e Pesquisa Albert Einstein, São Paulo, Brazil. abconf@yahoo.com
Ferreiro
Karina Nocelo
KN
Tomasi
Camilla
C
dos Santos
Renata Laurenti
RL
Moreira
Viviane Loureiro
VL
Marie
Suely Kazue Nagahashi
SK
Baltieri
Silvia Cristina
SC
Scaff
Milberto
M
Cohen
Leonardo G
LG
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