Corticomotor Excitability Effects of Peripheral Nerve Electrical Stimulation to the Paretic Arm in Stroke

Liu, Hao; Au-Yeung, Stephanie S.Y.

doi:10.1097/phm.0000000000000748

Cited by 14 publications

(5 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…PNS involves stimulating sensory nerves at the sensory threshold level to encourage motor area activation and stimulating a peripheral nerve to activate the corresponding primary sensory area. This is hypothesized to affect the GABA inhibitory system, increase the excitability of the motor cortex, and promote long-term potentiation of the motor area (Kaelin-Lang et al., 2002; Liu & Au-Yeung, 2017; Sawaki, Wu, Kaelin-Lang, & Cohen, 2006; Wu, van Gelderen, Hanakawa, Yaseen, & Cohen, 2005). Therefore, the reason for the effectiveness of PNS in restoring hand function might be that the stimulation of the median and ulnar nerves on the distal forearm encouraged the activation of the portion of the motor area controlling the hand.…”

Section: Discussionmentioning

confidence: 99%

Effects of peripheral nerve stimulation on paralysed upper limb functional recovery in chronic stroke patients undergoing low-frequency repetitive transcranial magnetic stimulation and occupational therapy: A pilot study

Maeda

Mutai

Toya³

et al. 2020

Hong Kong Journal of Occupational Therapy

View full text Add to dashboard Cite

Objective Upper limb paralysis, which is a sequela of stroke, limits patients’ activities of daily living and lowers quality of life. The objective of this study was to examine the effects of peripheral nerve stimulation on hemiparetic upper limb functional recovery in chronic stroke patients undergoing low-frequency repetitive transcranial magnetic stimulation and occupational therapy. Methods The subjects were chronic stroke patients who participated in a two-week inpatient programme including repetitive transcranial magnetic stimulation and occupational therapy. There were two groups of patients: the peripheral nerve stimulation group (11 patients who underwent peripheral nerve stimulation) and the control group (11 patients who previously participated in the same inpatient programme but without peripheral nerve stimulation, selected via propensity score matching). The peripheral nerve stimulation group had 1 h of peripheral nerve stimulation on the median and ulnar nerves during occupational therapy. The outcome measures were the Wolf Motor Function Test, Fugl-Meyer Assessment, and Motor Activity Log. Results Wolf Motor Function Test, Fugl-Meyer Assessment, and Motor Activity Log showed significant improvement after the intervention in the peripheral nerve stimulation group. Particularly, the Fugl-Meyer Assessment hand score significantly improved in the peripheral nerve stimulation group compared to that in the control group (median change: 2 versus 0; p = 0.021, r = 0.49). Conclusion The combined use of peripheral nerve stimulation with occupational therapy after repetitive transcranial magnetic stimulation may result in a better functional recovery of in hemiparetic upper limb. Peripheral nerve stimulation with stimulation above the sensory threshold and below the motor threshold is easy to combine with occupational therapy upper limb function training and is therefore clinically useful.

show abstract

Section: Discussionmentioning

confidence: 99%

Effects of peripheral nerve stimulation on paralysed upper limb functional recovery in chronic stroke patients undergoing low-frequency repetitive transcranial magnetic stimulation and occupational therapy: A pilot study

Maeda

Mutai

Toya³

et al. 2020

Hong Kong Journal of Occupational Therapy

View full text Add to dashboard Cite

show abstract

“… 59 In addition, peripheral nerve stimulation at ulnar and radial sites for 1 h has been revealed to increase corticomotor function and improve hand dexterity in patients with moderate to severe hemiparesis. 60 Thus, TENS may be utilized as a convenient tool for temporal function and muscle facilitation to maintain therapeutic effects with the provision of proper assistance. Prolonged periods of sensory stimulation, such as TENS combined with activity, can have beneficial effects for treating impaired function after stroke.…”

Section: Neurorehabilitation Therapy Could Potentially Be Taught and mentioning

confidence: 99%

Care for Patients with Stroke During the COVID-19 Pandemic: Physical Therapy and Rehabilitation Suggestions for Preventing Secondary Stroke

Wang

Chao

Wang

et al. 2020

Journal of Stroke and Cerebrovascular Diseases

View full text Add to dashboard Cite

Infection with the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes the development of the novel 2019 coronavirus disease (COVID-19) and associated clinical symptoms, which typically presents as an upper respiratory syndrome such as pneumonia. Growing evidence indicates an increased prevalence of neurological involvement (e.g., in the form of stroke) during virus infection. COVID-19 has been suggested to be more than a lung infection because it affects the vasculature of the lungs and other organs and increases the risk of thrombosis. Patients with stroke are vulnerable to secondary events as a result not only of their poor vascular condition but also of their lack of access to rehabilitation resources. Herein, we review current knowledge regarding the pathophysiology of COVID-19, its possible association with neurological involvement, and current drug therapies. Suggestions are also offered regarding the potential for current neurorehabilitation therapies to be taught and practiced at home.

show abstract

“…The effectiveness of ES for modulation of the excitability of the CST and improvement of dexterity performance of the paretic hand has been reported in patients with mild to moderate paralysis. 21 , 22 Moreover, the additive effect of MI and ES has been reported in healthy adults. Saito and colleagues reported that a combination of MI and peripheral nerve ES enhances the excitability of the CST compared with MI alone or ES alone.…”

Section: Introductionmentioning

confidence: 98%

Effect of the combination of motor imagery and electrical stimulation on upper extremity motor function in patients with chronic stroke: preliminary results

Okuyama

Ogura

Kawakami

et al. 2018

Ther Adv Neurol Disord

View full text Add to dashboard Cite

Background:The combination of motor imagery (MI) and afferent input with electrical stimulation (ES) enhances the excitability of the corticospinal tract compared with motor imagery alone or electrical stimulation alone. However, its therapeutic effect is unknown in patients with hemiparetic stroke. We performed a preliminary examination of the therapeutic effects of MI + ES on upper extremity (UE) motor function in patients with chronic stroke.Methods:A total of 10 patients with chronic stroke demonstrating severe hemiparesis participated. The imagined task was extension of the affected finger. Peripheral nerve electrical stimulation was applied to the radial nerve at the spiral groove. MI + ES intervention was conducted for 10 days. UE motor function as assessed with the Fugl–Meyer assessment UE motor score (FMA-UE), the amount of the affected UE use in daily life as assessed with a Motor Activity Log (MAL-AOU), and the degree of hypertonia in flexor muscles as assessed with the Modified Ashworth Scale (MAS) were evaluated before and after intervention. To assess the change in spinal neural circuits, reciprocal inhibition between forearm extensor and flexor muscles with the H reflex conditioning-test paradigm at interstimulus intervals (ISIs) of 0, 20, and 100 ms were measured before and after intervention.Results:UE motor function, the amount of the affected UE use, and muscle hypertonia in flexor muscles were significantly improved after MI + ES intervention (FMA-UE: p < 0.01, MAL-AOU: p < 0.01, MAS: p = 0.02). Neurophysiologically, the intervention induced restoration of reciprocal inhibition from the forearm extensor to the flexor muscles (ISI at 0 ms: p = 0.03, ISI at 20 ms: p = 0.03, ISI at 100 ms: p = 0.01).Conclusion:MI + ES intervention was effective for improving UE motor function in patients with severe paralysis.

show abstract

Corticomotor Excitability Effects of Peripheral Nerve Electrical Stimulation to the Paretic Arm in Stroke

Cited by 14 publications

References 31 publications

Effects of peripheral nerve stimulation on paralysed upper limb functional recovery in chronic stroke patients undergoing low-frequency repetitive transcranial magnetic stimulation and occupational therapy: A pilot study

Effects of peripheral nerve stimulation on paralysed upper limb functional recovery in chronic stroke patients undergoing low-frequency repetitive transcranial magnetic stimulation and occupational therapy: A pilot study

Care for Patients with Stroke During the COVID-19 Pandemic: Physical Therapy and Rehabilitation Suggestions for Preventing Secondary Stroke

Effect of the combination of motor imagery and electrical stimulation on upper extremity motor function in patients with chronic stroke: preliminary results

Contact Info

Product

Resources

About