Multi-sensory feedback therapy combined with task-oriented training on the hemiparetic upper limb in chronic stroke: study protocol for a pilot randomized controlled trial

Abstract

Background An important reason for the difficulty in recovering sensorimotor dysfunction of the upper extremity in chronic stroke survivors, is the lack of sensory function, such as tactile and proprioception feedback. In clinical practice, single sensory training is only for the restoration of sensory function. Increasing evidence suggests that use of task-oriented training (TOT) is a useful approach to hand motor rehabilitation. However, neither approach is optimal since both methods are trained only for specific functional recovery. Our hypothesis is that multi-sensory feedback therapy (MSFT) combined with TOT has the potential to provide stimulating tasks to restore both sensory and motor functions. The objective of the trial is to investigate whether novel MSFT is more effective in improving arm sensorimotor function in chronic stroke phase than single TOT.Methods/Design: The study will be conducted as a multicenter, randomized, double blind controlled trial. Participants (n = 90) will be randomised into three groups to compare the effect of the multi-sensory feedback therapy group against task-oriented training group and conventional group. Participants will receive treatment at the same intensity (60 min, 5 days a week, 4 weeks, 20 hours total). Primary outcome measures for assessment of sensory function are the Semmes Weinstein monofilaments examination (SWME),two-point discrimination test (2PD) test. Secondary measures are the Action Research Arm Test (ARAT)༌Nine-Hole Peg Test (NHPT), Wolf Motor Function Test (WMFT), Box and Blocks Test (BBT), Modified Barthel Index (MBI), Instrumental activities of daily living (IADL) and Generalized Anxiety Disorder 7-Item Scale (GAD-7). Outcome mearsures will be evaluated at baseline, post treatment, and two months follow-up. All assessments will be conducted by trained assessors blinded to treatment allocation.Discussion This study will determine the acceptability and efficacy of the intervention on the hemiparetic upper limb, it may be promising tools for sensorimotor functional recovery after stroke.

Effectiveness of technological interventions to improve upper limb motor function in people with stroke in low- and middle-income countries: Protocol for a systematic review and meta-analysis

“…We will address individual interventions in rehabilitation using technological devices 6-22 for the upper extremities such as robots, video games and virtual reality, telerehabilitation, wearable devices, neuroprosthetics or functional electrical stimulation, repetitive transcranial magnetic stimulation, transcranial direct current stimulation and brain-computer interfaces.…”

“…21 There are various technologies in rehabilitation that seek both to improve the functionality of the upper extremity and to reduce barriers in rehabilitation such as robots, which increase the intensity and dose of rehabilitation; video games and virtual reality, which encourage adherence; electronic devices such as sensors, which allow distant motor assessment; tele-rehabilitation that facilitates access to rehabilitation; brain-computer interfaces, which promote feedback; and non-invasive brain stimulation, which seeks to modulate cortical motor function. 6,22 However, the efficacy of these has been evaluated mostly in high-income countries, and there are no systematic reviews on the efficacy of these technological interventions in upper extremity rehabilitation in LMIC.…”

Research of Lower Limb Rehabilitation System with Multisensory Feedback Based on Virtual-Real Coordination

“…The use of multi-sensory assistive technology to replace and supplement residual sensory channels will make it possible for people with disabilities to interact normally. [13] E. Kristinsdóttir confirmed that combined vestibular, proprioceptive and fall-prevention training improve postural control, functional ability, confidence in ADL and might even decrease the risk of falling among elderly people [14] ; Yu-Hsiu Hung develop hand rehabilitation equipment based on multi-sensory stimulation therapy for stroke patients, and showed that vibration stimulation and mirror therapy were most effective [15] ; Jiali Lin confirmed that multi-sensory feedback therapy (MSFT) combined with TOT has the potential to provide stimulating tasks to restore both sensory and motor functions [16] .…”