Facilitation of Sensory and Motor Recovery by Thermal Intervention for the Hemiplegic Upper Limb in Acute Stroke Patients

Abstract

Background and Purpose-Thermal stimulation (TS) is commonly used in orthopedic rehabilitation, but the role of TS in the facilitation of sensorimotor recovery in hemiplegic patients remains unknown. This study addressed the issue of TS intervention in the facilitation of functional outcomes. Methods-Forty-six stroke survivors were randomly assigned to standard rehabilitation treatment and standard treatment plus TS (30 minutes daily for 6 weeks). Twenty-nine patients completed the experiment. Six measures, including Brunnstrom stage, modified motor assessment scale, grasping strength, angles of wrist extension and flexion, sensation by monofilament, and muscle tone by modified Ashworth scale, were performed weekly to evaluate sensory and motor functional outcomes. Results-The performance of Brunnstrom stage and wrist extension and sensation were improved significantly after TS intervention. Recovery rates of 6 measures after TS were significantly higher than those of the control, except for grasping. Similar muscle tones were found in both groups. Conclusion-TS

Understanding and supporting occupational therapists clinical decision-making for the management of upper limb post stoke sensory impairment

“…However Carey (1995) concluded that there is emerging evidence for a graded sensory retraining program. Several RCTS demonstrating some effectiveness for widely ranging interventions such as thermal stimulation (Chen et al, 2005), sensory re-education (Byl et al, 2003), sensorimotor training (Feys et al, 1998), and intermittent pneumatic stimulation (Cambier et al, 2003) were reviewed by Connell (2007) who found that most of the studies have small sample sizes, and were methodologically flawed. Consequently the author noted that it was difficult to reach conclusions on their effectiveness and further research was needed.…”

“…In summary, one systematic review, two literature reviews, and a clinical practice guideline have identified five RCTs (Byl et al, 2003;Cambier et al, 2003;Chen et al, 2005;Feys et al, 1998;Jongbled, Stacey & Brighton, 1989) review of the effectiveness of interventions for ULPSSI is warranted to address the current situation. Furthermore, it would also be important to actually see which sensory measures and interventions therapists are using to address ULPSSI and to understand their CDM as they choose how to address ULPSSI.…”

“…Two review authors reviewed full copies of the references to 48 studies. At the end of this process 13 studies met the inclusion criteria and study design requirements (randomised controlled trial or controlled clinical trial) (Acerra 2007;Burridge 2002;Byl 2003;Cambier 2003;Chen 2005;Feys 1998;Heldman 2000;Jongbloed 1989;Miller 2004;Poole 1990;Posteraro 2001;Wolny 2003;Yozbatiran 2006). We limited excluded studies listed in the review in accordance with section 7.2.5 of the Cochrane…”

“…Two of the 13 studies addressed adverse effects (Chen 2005;Feys 1998 were limited to increased muscle tone, which showed no difference between the groups and the fact that assessment took place during and after thermal stimulation.…”

“…In summary, one systematic review, two literature reviews, and a clinical practice guideline have identified five RCTs (Byl et al, 2003; Cambier et al, 2003;Chen et al, 2005; Feys et al, 1998; Jongbled, Stacey & Brighton, 1989) …”