Electrical Somatosensory Stimulation in Early Rehabilitation of Arm Paresis After Stroke: A Randomized Controlled Trial

Emma Ghaziani; Christian Couppé; Volkert Siersma; Mette Søndergaard; Hanne Christensen; S Peter Magnusson

doi:10.1177/1545968318799496

Electrical Somatosensory Stimulation in Early Rehabilitation of Arm Paresis After Stroke: A Randomized Controlled Trial

Emma Ghaziani, Christian Couppé, Volkert Siersma, Mette Søndergaard, Hanne Christensen, S Peter Magnusson

Institut for Klinisk Medicin

4 Citationer (Scopus)

Abstract

BACKGROUND: Arm paresis is present in 48% to 77% of acute stroke patients. Complete functional recovery is reported in only 12% to 34%. Although the arm recovery is most pronounced during the first 4 weeks poststroke, few studies examined the effect of upper extremity interventions during this period.

OBJECTIVE: To investigate the effect of electrical somatosensory stimulation (ESS) delivered during early stroke rehabilitation on the recovery of arm functioning.

METHODS: A total of 102 patients with arm paresis were randomized to a high-dose or a low-dose ESS group within 7 days poststroke according to our sample size estimation. The high-dose group received 1-hour ESS to the paretic arm daily during hospitalization immediately followed by minimum 15-minute task-oriented arm training that was considered a component of the usual rehabilitation. The low-dose group received a placebo ESS followed by identical training. Primary outcome-Box and Block Test (BBT); secondary outcomes-Fugl-Meyer Assessment (FMA), grip strength, pinch strength, perceptual threshold of touch, pain, and modified Rankin Scale (mRS); all recorded at baseline, postintervention and at 6 months poststroke.

RESULTS: There were no differences between the high-dose and the low-dose groups for any outcome measures at any time points. Improvements ⩾ minimal clinically important difference were observed for FMA, hand grip strength, and mRS in both groups.

CONCLUSIONS: Providing the present ESS protocol prior to arm training was equally beneficial as arm training alone. These results are valid for patients with mild-to-moderate stroke and moderate arm impairments. We cannot exclude benefits in patients with other characteristics, in other time intervals poststroke or using a different ESS protocol.

TRIAL REGISTRATION: ClinicalTrials.gov (NCT02250365).

Originalsprog	Engelsk
Tidsskrift	Neurorehabilitation and Neural Repair
Vol/bind	32
Udgave nummer	10
Sider (fra-til)	899-912
ISSN	1545-9683
DOI	https://doi.org/10.1177/1545968318799496
Status	Udgivet - 1 okt. 2018

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10.1177/1545968318799496

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title = "Electrical Somatosensory Stimulation in Early Rehabilitation of Arm Paresis After Stroke: A Randomized Controlled Trial",

abstract = "BACKGROUND: Arm paresis is present in 48% to 77% of acute stroke patients. Complete functional recovery is reported in only 12% to 34%. Although the arm recovery is most pronounced during the first 4 weeks poststroke, few studies examined the effect of upper extremity interventions during this period.OBJECTIVE: To investigate the effect of electrical somatosensory stimulation (ESS) delivered during early stroke rehabilitation on the recovery of arm functioning.METHODS: A total of 102 patients with arm paresis were randomized to a high-dose or a low-dose ESS group within 7 days poststroke according to our sample size estimation. The high-dose group received 1-hour ESS to the paretic arm daily during hospitalization immediately followed by minimum 15-minute task-oriented arm training that was considered a component of the usual rehabilitation. The low-dose group received a placebo ESS followed by identical training. Primary outcome-Box and Block Test (BBT); secondary outcomes-Fugl-Meyer Assessment (FMA), grip strength, pinch strength, perceptual threshold of touch, pain, and modified Rankin Scale (mRS); all recorded at baseline, postintervention and at 6 months poststroke.RESULTS: There were no differences between the high-dose and the low-dose groups for any outcome measures at any time points. Improvements ⩾ minimal clinically important difference were observed for FMA, hand grip strength, and mRS in both groups.CONCLUSIONS: Providing the present ESS protocol prior to arm training was equally beneficial as arm training alone. These results are valid for patients with mild-to-moderate stroke and moderate arm impairments. We cannot exclude benefits in patients with other characteristics, in other time intervals poststroke or using a different ESS protocol.TRIAL REGISTRATION: ClinicalTrials.gov (NCT02250365).",

keywords = "Aged, Aged, 80 and over, Arm/physiopathology, Electric Stimulation Therapy/methods, Female, Hand Strength/physiology, Humans, Male, Middle Aged, Paresis/etiology, Recovery of Function/physiology, Stroke/complications, Stroke Rehabilitation/methods, Treatment Outcome",

author = "Emma Ghaziani and Christian Coupp{\'e} and Volkert Siersma and Mette S{\o}ndergaard and Hanne Christensen and Magnusson, {S Peter}",

year = "2018",

month = oct,

day = "1",

doi = "10.1177/1545968318799496",

language = "English",

volume = "32",

pages = "899--912",

journal = "Neurorehabilitation and Neural Repair",

issn = "1545-9683",

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number = "10",

}

TY - JOUR

T1 - Electrical Somatosensory Stimulation in Early Rehabilitation of Arm Paresis After Stroke

T2 - A Randomized Controlled Trial

AU - Ghaziani, Emma

AU - Couppé, Christian

AU - Siersma, Volkert

AU - Søndergaard, Mette

AU - Christensen, Hanne

AU - Magnusson, S Peter

PY - 2018/10/1

Y1 - 2018/10/1

N2 - BACKGROUND: Arm paresis is present in 48% to 77% of acute stroke patients. Complete functional recovery is reported in only 12% to 34%. Although the arm recovery is most pronounced during the first 4 weeks poststroke, few studies examined the effect of upper extremity interventions during this period.OBJECTIVE: To investigate the effect of electrical somatosensory stimulation (ESS) delivered during early stroke rehabilitation on the recovery of arm functioning.METHODS: A total of 102 patients with arm paresis were randomized to a high-dose or a low-dose ESS group within 7 days poststroke according to our sample size estimation. The high-dose group received 1-hour ESS to the paretic arm daily during hospitalization immediately followed by minimum 15-minute task-oriented arm training that was considered a component of the usual rehabilitation. The low-dose group received a placebo ESS followed by identical training. Primary outcome-Box and Block Test (BBT); secondary outcomes-Fugl-Meyer Assessment (FMA), grip strength, pinch strength, perceptual threshold of touch, pain, and modified Rankin Scale (mRS); all recorded at baseline, postintervention and at 6 months poststroke.RESULTS: There were no differences between the high-dose and the low-dose groups for any outcome measures at any time points. Improvements ⩾ minimal clinically important difference were observed for FMA, hand grip strength, and mRS in both groups.CONCLUSIONS: Providing the present ESS protocol prior to arm training was equally beneficial as arm training alone. These results are valid for patients with mild-to-moderate stroke and moderate arm impairments. We cannot exclude benefits in patients with other characteristics, in other time intervals poststroke or using a different ESS protocol.TRIAL REGISTRATION: ClinicalTrials.gov (NCT02250365).

AB - BACKGROUND: Arm paresis is present in 48% to 77% of acute stroke patients. Complete functional recovery is reported in only 12% to 34%. Although the arm recovery is most pronounced during the first 4 weeks poststroke, few studies examined the effect of upper extremity interventions during this period.OBJECTIVE: To investigate the effect of electrical somatosensory stimulation (ESS) delivered during early stroke rehabilitation on the recovery of arm functioning.METHODS: A total of 102 patients with arm paresis were randomized to a high-dose or a low-dose ESS group within 7 days poststroke according to our sample size estimation. The high-dose group received 1-hour ESS to the paretic arm daily during hospitalization immediately followed by minimum 15-minute task-oriented arm training that was considered a component of the usual rehabilitation. The low-dose group received a placebo ESS followed by identical training. Primary outcome-Box and Block Test (BBT); secondary outcomes-Fugl-Meyer Assessment (FMA), grip strength, pinch strength, perceptual threshold of touch, pain, and modified Rankin Scale (mRS); all recorded at baseline, postintervention and at 6 months poststroke.RESULTS: There were no differences between the high-dose and the low-dose groups for any outcome measures at any time points. Improvements ⩾ minimal clinically important difference were observed for FMA, hand grip strength, and mRS in both groups.CONCLUSIONS: Providing the present ESS protocol prior to arm training was equally beneficial as arm training alone. These results are valid for patients with mild-to-moderate stroke and moderate arm impairments. We cannot exclude benefits in patients with other characteristics, in other time intervals poststroke or using a different ESS protocol.TRIAL REGISTRATION: ClinicalTrials.gov (NCT02250365).

KW - Aged

KW - Aged, 80 and over

KW - Arm/physiopathology

KW - Electric Stimulation Therapy/methods

KW - Female

KW - Hand Strength/physiology

KW - Humans

KW - Male

KW - Middle Aged

KW - Paresis/etiology

KW - Recovery of Function/physiology

KW - Stroke/complications

KW - Stroke Rehabilitation/methods

KW - Treatment Outcome

U2 - 10.1177/1545968318799496

DO - 10.1177/1545968318799496

M3 - Journal article

C2 - 30251591

SN - 1545-9683

VL - 32

SP - 899

EP - 912

JO - Neurorehabilitation and Neural Repair

JF - Neurorehabilitation and Neural Repair

IS - 10

ER -

Electrical Somatosensory Stimulation in Early Rehabilitation of Arm Paresis After Stroke: A Randomized Controlled Trial

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