Effect of a Novel Perturbation-Based Pinch Task Training on Sensorimotor Performance of Upper Extremity for Patients With Chronic Stroke: A Pilot Randomized Controlled Trial

Hsiu-Yun Hsu; Ta-Shen Kuan; Ching-Liang Tsai; Po-Ting Wu; Yao-Lung Kuo; Fong-Chin Su; Li-Chieh Kuo

doi:10.1016/j.apmr.2020.11.004

Effect of a Novel Perturbation-Based Pinch Task Training on Sensorimotor Performance of Upper Extremity for Patients With Chronic Stroke: A Pilot Randomized Controlled Trial

Arch Phys Med Rehabil. 2021 May;102(5):811-818. doi: 10.1016/j.apmr.2020.11.004. Epub 2020 Dec 2.

Authors

Hsiu-Yun Hsu¹, Ta-Shen Kuan², Ching-Liang Tsai², Po-Ting Wu³, Yao-Lung Kuo⁴, Fong-Chin Su⁵, Li-Chieh Kuo⁶

Affiliations

¹ Department of Physical Medicine and Rehabilitation, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan; Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan.
² Department of Physical Medicine and Rehabilitation, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan.
³ Department of Orthopedics, College of Medicine, National Cheng Kung University, Tainan.
⁴ Department of Surgery, College of Medicine, National Cheng Kung University, College of Medicine, Tainan.
⁵ Department of Biomedical Engineering, College of Engineering, National Cheng Kung University, Tainan; Medical Device Innovation Center, National Cheng Kung University, Tainan, Taiwan.
⁶ Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan; Medical Device Innovation Center, National Cheng Kung University, Tainan, Taiwan. Electronic address: jkkuo@mail.ncku.edu.tw.

PMID: 33278364
DOI: 10.1016/j.apmr.2020.11.004

Abstract

Objective: To investigate the effects of perturbation-based pinch task training on the sensorimotor performance of the upper extremities of patients with chronic stroke via a novel vibrotactile therapy system.

Design: A single-blinded randomized controlled trial.

Setting: A university hospital.

Participants: Patients with chronic stroke (N=19) randomly assigned into either an experimental group or a control group completed the study.

Interventions: In addition to 10 minutes of traditional sensorimotor facilitation, each participant in the experimental group received 20 minutes of perturbation-based pinch task training in each treatment session, and the controls received 20 minutes of task-specific motor training twice a week for 6 weeks.

Main outcome measures: The scores for the primary outcome, Semmes-Weinstein monofilament (SWM), and those for the secondary outcomes, Fugl-Meyer Assessment (FMA), amount of use, quality of movement (QOM) on the Motor Activity Log (MAL) scale, and box and block test (BBT), were recorded. All outcome measures were recorded at pretreatment, post treatment, and 12-week follow-up.

Results: There were statistically significant between-group differences in the training-induced improvements revealed in the SWM results (P=.04) immediately after training and in the BBT results (P=.05) at the 12-week follow-up. The changes in muscle tone and in the QOM, SWM, and BBT scores indicated statistically significant improvements after 12 sessions of treatment for the experimental group. For the control group, a significant statistical improvement was found in the wrist (P<.001) and coordination (P=.01) component of the FMA score.

Conclusions: This study indicated that the perturbation-based pinch task training has beneficial effects on sensory restoration of the affected thumb in patients with chronic stroke.

Trial registration: ClinicalTrials.gov NCT03798340.

Keywords: Rehabilitation; Sensation; Stroke; Upper extremity.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Humans
Middle Aged
Pilot Projects
Pinch Strength / physiology*
Recovery of Function
Sensory Thresholds
Single-Blind Method
Stroke Rehabilitation / instrumentation
Stroke Rehabilitation / methods*
Surveys and Questionnaires
Thumb / innervation
Upper Extremity / physiopathology*
Vibration / therapeutic use*

Associated data

ClinicalTrials.gov/NCT03798340