Article

Somatosensory stimulation (SS) is a potential adjuvant to stroke
rehabilitation, but the effect on function needs further investigation.
OBJECTIVE: To explore the effect of combining SS with task-specific training
(TST) on upper limb function and arm use in chronic stroke survivors and
determine underlying mechanisms. METHODS: In this double-blinded randomized
controlled trial (ISRCTN 05542931), 33 patients (mean 37.7 months poststroke)
were block randomized to 2 groups: active or sham SS. They received 12 sessions
of 2 hours of SS (active or sham) to all 3 upper limb nerves immediately before
30 minutes of TST. The primary outcome was the Action Research Arm Test (ARAT)
score. Secondary outcomes were time to perform the ARAT, Fugl-Meyer Assessment
score (FM), Motor Activity Log (MAL), and Goal Attainment Scale (GAS). Underlying
mechanisms were explored using transcranial magnetic stimulation
stimulus-response curves and intracortical inhibition. Outcomes were assessed at
baseline, immediately following the intervention (mean 2 days), and 3 and 6
months (mean 96 and 190 days) after the intervention. RESULTS: The active group
(n = 16) demonstrated greater improvement in ARAT score and time immediately
postintervention (between-group difference; P < .05), but not at 3- or 6-month
follow-ups (P > .2). Within-group improvements were seen for both groups for ARAT
and GAS, but for the active group only for FM and MAL
(P < .05). Corticospinal
excitability did not change. CONCLUSIONS: Long-lasting improvements in upper limb
function were observed following TST. Additional benefit of SS was seen
immediately post treatment, but did not persist and the underlying mechanisms
remain unclear.
CI - (c) The Author(s) 2014.
- Double aveugle

Langue : ANGLAIS