Article

Previous works showed potentially beneficial effects of a single
session of peripheral nerve sensory stimulation (PSS) on motor function of a
paretic hand in patients with subacute and chronic stroke. OBJECTIVE: To
investigate the influence of the use of different stimulus intensities over
multiple sessions (repetitive PSS [RPSS]) paired with motor training. METHODS: To
address this question, 22 patients were randomized within the second month after
a single hemispheric stroke in a parallel design to application of 2-hour RPSS at
1 of 2 stimulus intensities immediately preceding motor training, 3 times a week,
for 1 month. Jebsen-Taylor test (JTT, primary endpoint measure), pinch force,
Functional Independence Measure (FIM), and corticomotor excitability to
transcranial magnetic stimulation were measured before and after the end of the
treatment month. JTT, FIM scores, and pinch force were reevaluated 2 to 3 months
after the end of the treatment. RESULTS: Baseline motor function tests were
comparable across the 2 RPSS intensity groups. JTT improved significantly in the
lower intensity RPSS group but not in the higher intensity RPSS group at month 1.
This difference between the 2 groups reduced by months 2 to 3. CONCLUSIONS: These
results indicate that multiple sessions of RPSS could facilitate training effects
on motor function after subacute stroke depending on the intensity of
stimulation. It is proposed that careful dose-response studies are needed to
optimize parameters of RPSS stimulation before designing costly, larger,
double-blind, multicenter clinical trials.

Langue : ANGLAIS