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).
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