NERVE STIMULATION ENHANCES TASK-ORIENTED TRAINING FOR MODERATE-TO-SEVERE HEMIPARESIS 3-12 MONTHS AFTER STROKE: A RANDOMIZED TRIAL

Objective Determine whether somatosensory stimulation affects outcomes of motor training for moderate-to-severe upper extremity hemiparesis less than 12 months post-stroke. Design 55 adults participated in 18 intervention sessions pairing 2 hours of active (n=33) or sham (n=22) somatosensory stimulation with 4 hours of intensive task-oriented motor training. Wolf Motor Function Test, Action Research Arm Test, Fugl-Meyer Assessment, and Stroke Impact Scale were administered at baseline, post-intervention, and 1- and 4-month follow-up. Results Statistically significant between-groups differences favored the active condition on Wolf Motor Function Test at post (p=0.04) and Action Research Arm Test at post (p=0.02), 1-month (p=0.01), and 4-month (p=0.01) but favored the sham condition on Stroke Impact Scale at 1-month (p=0.03). There were no significant between-groups differences on Fugl-Meyer Assessment. Conclusion Somatosensory stimulation can improve objective outcomes of motor training for moderate-to-severe hemiparesis less than 12 months after stroke, although the magnitude of between-groups differences in this study needs to be determined if they are clinically relevant. Future studies should investigate the intervention's impact on disability and functional recovery for this population as well as neurophysiological mechanisms underlying intervention effects. Corresponding author: Lumy Sawaki, MD, PhD, University of Kentucky Department of Physical Medicine and Rehabilitation at Cardinal Hill Hospital, 2050 Versailles Road, Lexington, KY 40504 (lsawa2@uky.edu; phone 859/323-6226; fax 859/323-1123) Disclosures: This study was funded by the National Institutes of Health R01 NIH HD056002, ARRA Administrative Supplement, and the Cardinal Hill Rehabilitation Hospital Endowed Chair in Stroke and Spinal Cord Injury Rehabilitation (0705129700). There are no financial benefits to the authors. Results of this study were first presented in poster form at the 2015 Conference of the American Society of Neurorehabilitation. There are no conflicts of interest related to this research or this manuscript. The clinical trial registration number with clinicaltrials.gov is NCT03124186. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2klDOkB