Electrical stimulation enhances sensory recovery: a randomized controlled trial.
OBJECTIVE
Brief postsurgical electrical stimulation (ES) has been shown to enhance peripheral nerve regeneration in animal models following axotomy and crush injury. However, whether this treatment is beneficial in humans with sensory nerve injury has not been tested. The goal of this study was to test the hypothesis that ES would enhance sensory nerve regeneration following digital nerve transection compared to surgery alone.


METHODS
Patients with complete digital nerve transection underwent epineurial nerve repair. After coaptation of the severed nerve ends, fine wire electrodes were implanted before skin closure. Postoperatively, patients were randomized to receiving either 1 hour of 20Hz continuous ES or sham stimulation in a double-blinded manner. Patients were followed monthly for 6 months by a blinded evaluator to monitor physiological recovery of spatial discrimination, pressure threshold, and quantitative small fiber sensory testing. Functional disability was measured using the Disability of Arm, Shoulder, and Hand questionnaire.


RESULTS
A total of 36 patients were recruited, with 18 in each group. Those in the ES group showed consistently greater improvements in all sensory modalities by 5 to 6 months postoperatively compared to the controls. Although there was a trend of greater functional improvements in the ES group, it was not statistically significant (p > 0.01).


CONCLUSIONS
Postsurgical ES enhanced sensory reinnervation in patients who sustained complete digital nerve transection. The conferred benefits apply to a wide range of sensory functions.
Division of Plastic Surgery, Department of Surgery, Faculty of Medicine and Dentistry.
Joshua N
JN
Wong
Division of Plastic Surgery, Department of Surgery, Faculty of Medicine and Dentistry.
Jaret L
JL
Olson
Division of Plastic Surgery, Department of Surgery, Faculty of Medicine and Dentistry.
Michael J
MJ
Morhart
Division of Physical Medicine and Rehabilitation, Faculty of Medicine and Dentistry.|Center for Neuroscience, University of Alberta, Edmonton, Alberta, Canada.
K Ming
KM
Chan
D000328:Adult; D004185:Disability Evaluation; D004311:Double-Blind Method; D004599:Electric Stimulation Therapy / Q000379:methods*; D004567:Electrodes, Implanted; D005260:Female; D005383:Finger Injuries / Q000601:surgery / Q000628:therapy*; D005385:Fingers / Q000294:innervation* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009416:Nerve Regeneration / Q000502:physiology*; D010525:Peripheral Nerves / Q000502:physiology* / Q000601:surgery; D020127:Recovery of Function / Q000502:physiology*; D016896:Treatment Outcome