Abstract
Background.
Enhancement of sensory input in the form of repetitive peripheral
sensory stimulation (RPSS) can enhance excitability of the motor cortex
and upper limb performance.
Objective. To perform a systematic
review and meta-analysis of effects of RPSS compared with control
stimulation on improvement of motor outcomes in the upper limb of
subjects with stroke.
Methods. We searched studies published
between 1948 and December 2017 and selected 5 studies that provided
individual data and applied a specific paradigm of stimulation (trains
of 1-ms pulses at 10 Hz, delivered at 1 Hz). Continuous data were
analyzed with means and standard deviations of differences in
performance before and after active or control interventions. Adverse
events were also assessed.
Results. There was a statistically
significant beneficial effect of RPSS on motor performance (standard
mean difference between active and control RPSS, 0.67; 95% CI,
0.09-1.24; I2 = 65%). Only 1 study included subjects
in the subacute phase after stroke. Subgroup analysis of studies that
only included subjects in the chronic phase showed a significant effect
(1.04; 95% CI, 0.66-1.42) with no heterogeneity. Significant results
were obtained for outcomes of body structure and function as well as for
outcomes of activity limitation according to the International
Classification of Function, Disability and Health, when only studies
that included subjects in the chronic phase were analyzed. No serious
adverse events were reported.
Conclusions. RPSS is a safe
intervention with potential to become an adjuvant tool for upper
extremity paresis rehabilitation in subjects with stroke in the chronic
phase.
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