Date of Paper/Work

5-2014

Type of Paper/Work

Research Project

Degree Name

Doctor of Physical Therapy (DPT)

Department

Physical Therapy

First Advisor

Lisa L. Dutton

Abstract

BACKGROUND AND PURPOSE:

Post-stroke sensory dysfunction has been observedin more than 50-60% of all patients and negatively impacts motor control. Afferent input through sensory amplitude electrical stimulation (SES) has been associated with increased cortical excitability and plasticity, having a positive impact on the generation of skilled movement and function. The purpose of this study was to investigate the effect of lower extremity SES on motor and sensory recovery and function after first stroke for adult patients undergoing acute rehabilitation.

METHODS:

This study is part of an ongoing double blind, randomized controlled trial. Inclusion criteria: admitted to inpatient rehabilitation with first stroke, medically stable, sensory and/or motor dysfunction, and scored ≥26 on the Montreal Cognitive Assessment Score. Exclusion criteria: pre-morbid neurologic or balance disorders and a projected length of stay less than 6 days.The experimental group received SES and control group received sham stimulation over the peroneal nerve for 60 minutes daily prior to physical therapy. Both interventions were provided six days/week throughout the rehabilitation stay; subjects received an average of 12 treatments. Outcome measures included the Fugl-Meyer lower extremity sensory assessment, Lower Extremity Motricity Index (LEMI), Berg Balance Scale (BBS), gait speed, and the Functional Independence Measure (FIM).

RESULTS: Forty-four patients were screened over six months: three patients met inclusion/exclusion criteria and consented to participate. Two females, one in the control group and one in the experimental group; and one male in the control group were recruited with an average age of 62.7, all with subcortical stroke. Subject one was seven days post-stroke, subjects two and three were five days post-stroke. Subjects in both groups showed meaningful improvement on LEMI and BBS. Only those in the contro group showed meaningful improvement on the FIM. Fugl-Meyer was normal for all subjects at baseline. Gait speed could not be assessed due to subjects’ inability to complete the test upon initial evaluation. The experimental subject showed the greatest amount of change in the LEMI compared to the control group.

CONCLUSION: Due to a small sample size the results cannot be generalized to all who have experienced stroke. Additional research and subjects are necessary to gain a better understanding of how peripheral sensory stimulation can affect sensory recovery and functional gain following acute stroke.

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