title: Sensory Barrage Stimulation in the Treatment of Elbow Spasticity: A Crossover Double Blind Randomized Pilot Trial.
abstract: OBJECTIVE
  To assess the feasibility of using a novel form of multichannel electrical stimulation, termed Sensory Barrage Stimulation (SBS) for the treatment of spasticity affecting the elbow flexor muscles and to compare this with conventional single-channel TENS stimulation.
  
  
  METHODS
  Altogether ten participants with spasticity of the flexor muscles of the elbow of Grade 2 or above on the Modified Ashworth Scale (MAS) were recruited to this crossover double blind randomized trial. The participants received two intervention sessions (SBS and TENS), one week apart in a randomized order. Both interventions were applied over the triceps brachii on the affected arm for a duration of 60 minutes. Spasticity was measured using the MAS. Secondary outcome measures were self-reported change in spasticity, measured on a visual analog scale (VAS, 0-100), and therapist-rated strength of elbow extension and strength of elbow flexion. Measurements were taken immediately before each intervention was applied, immediately after the intervention, and one hour after the intervention.
  
  
  RESULTS
  Immediately after stimulation spasticity showed a significant reduction for both TENS and SBS groups assessed by MAS -0.9 ± 0.2 vs. -1.1 ± 0.2 and by VAS -15 ± 3 vs. -31 ± 8. For SBS this improvement in MAS was still present at one hour after the stimulation, but not for TENS. Altogether seven SBS responders and four TENS responders were identified.
  
  
  CONCLUSIONS
  This study demonstrates the feasibility and practicality of applying the new concept of SBS. Promising results indicate it causes a reduction in spasticity.
authors.affiliation: Department of Medical Physics & Clinical Engineering, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.|The National Institute for Health Research Devices for Dignity Healthcare Technology Cooperative, Royal Hallamshire Hospital, Sheffield, UK.
authors.forename: Martin
authors.initials: M
authors.lastname: Slovak
authors.affiliation: Department of Neuroscience, Royal Hallamshire Hospital, Sheffield, UK.
authors.forename: Joseph
authors.initials: J
authors.lastname: Chindo
authors.affiliation: Department of Neurology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
authors.forename: Krishnan Padmakumari Sivaraman
authors.initials: KP
authors.lastname: Nair
authors.affiliation: Department of Medical Physics & Clinical Engineering, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
authors.forename: Mark L
authors.initials: ML
authors.lastname: Reeves
authors.affiliation: Centre for Sports Engineering Research, Sheffield Hallam University, Broomgrove Teaching Block, Sheffield, UK.
authors.forename: Ben
authors.initials: B
authors.lastname: Heller
authors.affiliation: Department of Medical Physics & Clinical Engineering, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
authors.forename: Anthony T
authors.initials: AT
authors.lastname: Barker
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004550:Elbow; D004599:Electric Stimulation Therapy / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009128:Muscle Spasticity / Q000628:therapy*; D010865:Pilot Projects; D004561:Transcutaneous Electric Nerve Stimulation; D016896:Treatment Outcome; D055815:Young Adult
keywords: Crossover trial; electrical stimulation; muscle spasticity; sensory stimulation; transcutaneous electrical nerve stimulation