Chronicity of Stroke Does Not Affect Outcomes of Somatosensory Stimulation Paired With Task-Oriented Motor Training: A Secondary Analysis of a Randomized Controlled Trial

• Main Authors: Cheryl Carrico, MS, OT/L, Nicholas Annichiarico, DO, MS, Elizabeth Salmon Powell, MS, Philip M. Westgate, PhD, Lumy Sawaki, MD, PhD
• Format: Article
• Language: English
• Published: Elsevier 2019-06-01
• Series: Archives of Rehabilitation Research and Clinical Translation
• Online Access: http://www.sciencedirect.com/science/article/pii/S2590109519300047

Objective: To determine whether chronicity influences outcomes of somatosensory stimulation paired with task-oriented motor training for participants with severe-to-moderate upper extremity hemiparesis. Design: Spearman correlations were used to retrospectively analyze outcomes of a randomized trial. Setting: University research laboratory at a rehabilitation hospital. Participants: Adults, ranging between 3 and 12 months poststroke (N=55). Interventions: About 18 sessions pairing either 2 hours of active (n=33) or sham (n=22) somatosensory stimulation with 4 hours of intensive task-oriented motor training. Main Outcome Measures: The Wolf Motor Function Test (primary), Action Research Arm Test, Stroke Impact Scale, and Fugl-Meyer Assessment were collected as outcome measures. Analyses evaluated whether within-group chronicity correlated with pre-post changes on primary and secondary outcome measures of motor performance. Results: Both groups exhibited improvements on all outcome measures. No significant correlations between chronicity poststroke and the amount of motor recovery were found. Conclusion: Somatosensory stimulation improved motor recovery compared with sham treatment in cases of severe-to-moderate hemiparesis between 3 and 12 months poststroke; and the extent of recovery did not correlate with baseline levels of stroke chronicity. Future studies should investigate a wider period of inclusion, patterns of corticospinal reorganization, differences between cortical and subcortical strokes, and include long-term follow-up periods. Keywords: Humans, Occupational therapy, Rehabilitation, Transcutaneous electric nerve stimulation, Upper extremity