Combined Brain and Peripheral Nerve Stimulation in Chronic Stroke Patients With Moderate to Severe Motor Impairment

Content Provider	Scilit
Author	Menezes, Isabella S. Cohen, Leonardo G. Pt, Eduardo A. Mello Md, André G. Machado Peckham, Paul Hunter Anjos, Sarah M. Siqueira, Inara L. Conti, Juliana Plow, Ela B. Md, Adriana B. Conforto Pt, Ms Isabella S. Menezes Ms, Bs Paul Hunter Peckham Ot, Ms Sarah M. Anjos Ugs, Inara L. Siqueira Ot, Juliana Conti Pt, Ela B. Plow
Copyright Year	2017
Description	Journal: Neuromodulation: Technology At the Neural Interface Objectives To evaluate effects of somatosensory stimulation in the form of repetitive peripheral nerve sensory stimulation (RPSS) in combination with transcranial direct current stimulation (tDCS), tDCS alone, RPSS alone, or sham RPSS + tDCS as add‐on interventions to training of wrist extension with functional electrical stimulation (FES), in chronic stroke patients with moderate to severe upper limb impairments in a crossover design. We hypothesized that the combination of RPSS and tDCS would enhance the effects of FES on active range of movement (ROM) of the paretic wrist to a greater extent than RPSS alone, tDCS alone or sham RPSS + tDCS. Materials and Methods The primary outcome was the active ROM of extension of the paretic wrist. Secondary outcomes were ROM of wrist flexion, grasp, and pinch strength of the paretic and nonparetic upper limbs, and ROM of wrist extension of the nonparetic wrist. Outcomes were blindly evaluated before and after each intervention. Analysis of variance with repeated measures with factors “session” and “time” was performed. Results After screening 2499 subjects, 22 were included. Data from 20 subjects were analyzed. There were significant effects of “time” for grasp force of the paretic limb and for ROM of wrist extension of the nonparetic limb, but no effects of “session” or interaction “session x time.” There were no significant effects of “session,” “time,” or interaction “session x time” regarding other outcomes. Conclusions Single sessions of PSS + tDCS, tDCS alone, or RPSS alone did not improve training effects in chronic stroke patients with moderate to severe impairment.
Related Links	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5801160/pdf https://onlinelibrary.wiley.com/doi/pdf/10.1111/ner.12717
Ending Page	183
Page Count	8
Starting Page	176
ISSN	10947159
e-ISSN	15251403
DOI	10.1111/ner.12717
Journal	Neuromodulation: Technology At the Neural Interface
Issue Number	2
Volume Number	21
Language	English
Publisher	Elsevier BV
Publisher Date	2017-10-25
Access Restriction	Open
Subject Keyword	Journal: Neuromodulation: Technology At the Neural Interface Electric Stimulation Therapy Stroke Rehabilitation Transcranial Direct Current Stimulation Transcutaneous Electric Nerve Stimulation
Content Type	Text
Resource Type	Article
Subject	Neurology Neurology (clinical) Anesthesiology and Pain Medicine