title: Effects of noxious versus innocuous thermal stimulation on lower extremity motor recovery 3 months after stroke.
abstract: OBJECTIVE
  To examine the effects of thermal stimulation (TS) on the lower extremity (LE) movement and function in patients with stroke.
  
  
  METHODS
  A double-blinded randomized controlled trial.
  
  
  METHODS
  A university hospital.
  
  
  METHODS
  Patients (N=34) at least 3 months after stroke were randomly assigned into the experimental and the control groups.
  
  
  METHODS
  In addition to regular rehabilitation, the experimental group received a 30-minute noxious TS protocol (heat pain 46-47°C/cold pain 2-3°C) 3days/wk for 8 weeks, and the control group received a 30-minute innocuous TS protocol (heat 40-41°C/cold 23-24°C) 3d/wk for 8 weeks.
  
  
  METHODS
  The Low Extremity subscale of the Stroke Rehabilitation Assessment of Movement (LE-STREAM), the Mobility subscale of STREAM (Mob-STREAM), the Functional Ambulation Category (FAC), the Barthel Index (BI), the Postural Assessment Scale for Stroke Patients (PASS), and the Modified Ashworth Scale (MAS) were administered by a blinded rater at baseline, posttreatment (8wk), and follow-up (12wk).
  
  
  RESULTS
  Twenty-three participants completed the study protocol and all outcome measurements. No preexisting group differences between the experimental group (n=11) and the control group (n=12) were found on demographic and clinical variables. Compared with baseline, the experimental group showed significant improvements at posttreatment and follow-up on the LE-STREAM, Mob-STREAM, FAC, and BI (P<.05) while the control group showed no significant improvements for all outcome measures. As for the between-group comparison, significant differences were seen at follow-up (12wk) on the LE-STREAM, Mob-STREAM, BI, and MAS.
  
  
  CONCLUSIONS
  Our findings indicate that an 8-week program of noxious TS combined with a traditional stroke rehabilitation program can improve the LE-related movement and function in patients with stroke for more than 3 months.
authors.affiliation: Department and Graduate Institute of Neurology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Hsin-Wen
authors.initials: HW
authors.lastname: Hsu
authors.forename: Chia-Ling
authors.initials: CL
authors.lastname: Lee
authors.forename: Miao-Ju
authors.initials: MJ
authors.lastname: Hsu
authors.forename: Hung-Chia
authors.initials: HC
authors.lastname: Wu
authors.forename: Roxane
authors.initials: R
authors.lastname: Lin
authors.forename: Ching-Lin
authors.initials: CL
authors.lastname: Hsieh
authors.forename: Jau-Hong
authors.initials: JH
authors.lastname: Lin
mesh_terms: D000328:Adult; D000368:Aged; D017679:Cryotherapy; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006979:Hyperthermia, Induced; D035002:Lower Extremity / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010291:Paresis / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D020127:Recovery of Function / Q000502:physiology*; D020521:Stroke / Q000150:complications / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D013997:Time Factors; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology