In a nutshell
This trial examined whether nerve stimulation combined with motor function training improved motor function in stroke patients. They found that peripheral nerve stimulation and motor function training is effective for patients with severe upper extremity motor impairment.
Some background
Stroke patients are commonly affected by post-stroke physical and cognitive disabilities, including impairment and loss of motor function. Impaired upper extremity movement (UE) is very common among stroke patients and can result in the patient having no active movement.
Peripheral nerve stimulation (PNS) involves applying an electrical current to the nerves that control muscles, to help contraction during functional activity. There is evidence to suggest that PNS coupled with motor training after stroke increases motor function. Prior studies included patients with mild to moderate disabilities. Therefore, it is unknown whether PNS combined with motor function training would be beneficial for patients with severe UE impairment.
Methods & findings
This study aimed to determine whether combining PNS with motor function training would be effective for patients with severe UE impairment. The study included a total of 36 patients with chronic severe UE impairment. 18 patients were treated with PNS immediately before motor function training. The remaining 18 patients had sham PNS (not active) before motor function training.
Motor function, UE motor ability, and arm function were measured before treatment, just after treatment, and 1 month after treatment.
The study used three testing methods. The fugl-meyer assessment (FMA) measures motor function in stroke patients. The wolf motor function test (WMFT) quantifies UE motor ability. The action research arm test (ARAT) measures changes in limb function specific to arm related activities.
There were no treatment complications or adverse side effects.
All tests used showed significant improvement with PNS stimulation both immediately after treatment and at 1 month follow up, compared to the patients’ scores before the study. The sham group showed significant improvement right after treatment, but not at 1 month follow up.
Improvements seen in the active PNS group were greater than those in the sham group. However, no patient saw full recovery of movement.
The bottom line
The authors concluded that peripheral nerve stimulation combined with motor function training is effective for patients with severe UE impairment.
The fine print
This study looked at improvements in the short-term. Longer term studies (6 months or more) are needed, with larger numbers of patients.
One author of this study is a consultant to a funding body of the study.
Published By :
Stroke
Date :
May 19, 2016
