title: Deafferentation of the affected arm: a method to improve rehabilitation?
abstract: OBJECTIVE
  Reduced somatosensation is a common impairment after stroke. This somatosensory deficit is known to be a reliable predictor of poor rehabilitation outcome. Several methods of physical therapy have addressed this problem, but with only moderate success. Here, we used a new neural plasticity-based approach, ie, a simple, inexpensive, pharmacologically induced temporary functional deafferentation (TFD) of the forearm to investigate whether TFD might result in beneficial effects on the somatosensory sensibility and motor capacity of the stroke-affected hand.
  
  
  METHODS
  Examination was performed over 2 consecutive days of an efficient rehabilitation program for stroke patients referred to as constraint-induced movement therapy. Patients were deafferented on one of these days but not on the other (placebo session). The order of deafferentation and nondeafferentation was counterbalanced across patients. TFD of the stroke-affected forearm was realized using an anesthetic cream. Somatosensory abilities were assessed by a Grating orienting task, and a shape-sorter drum task was used to test motor performance. Both tests were performed each day before and after the constraint-induced movement therapy training session.
  
  
  RESULTS
  We found significantly better outcomes for Grating orienting task and shape-sorter drum task after TFD on the forearm as compared to placebo, indicating increased somatosensory abilities and motor performance in stroke patients using the simple TFD procedure.
  
  
  CONCLUSIONS
  The improvement was achieved during the course of one of the best established poststroke rehabilitation programs, suggesting that TFD on the more affected forearm might become an efficient additional tool in stroke rehabilitation.
authors: Biological and Clinical Psychology Department, Friedrich Schiller University, and Department of Neurology, University Hospital, Am Steiger 3H1, Jena, D-07743, Germany. thomas.weiss@uni-jena.de
authors: Thomas
authors: T
authors: Weiss
authors: Elisabeth
authors: E
authors: Sens
authors: Ulrike
authors: U
authors: Teschner
authors: Winfried
authors: W
authors: Meissner
authors: Christoph
authors: C
authors: Preul
authors: Otto W
authors: OW
authors: Witte
authors: Wolfgang H R
authors: WH
authors: Miltner
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000777:Anesthetics / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D002648:Child; D005260:Female; D005542:Forearm / Q000294:innervation* / Q000503:physiopathology; D006225:Hand / Q000294:innervation / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015915:Motion Therapy, Continuous Passive / Q000379:methods*; D009473:Neuronal Plasticity / Q000187:drug effects / Q000502:physiology; D009824:Ointments; D013003:Somatosensory Cortex / Q000187:drug effects / Q000503:physiopathology; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome
chemical_list: D000777:Anesthetics; D009824:Ointments