University of São Paulo, São Paulo, Brazil.
Neurorehabil Neural Repair. 2013 Jul-Aug;27(6):483-90. doi: 10.1177/1545968313478488. Epub 2013 Mar 11.
Somatosensory stimulation in the form of repetitive peripheral nerve stimulation (RPSS) is a promising strategy to improve motor function of the upper limb in chronic stroke. Home-based RPSS may be an alternative to hospital-based RPSS.
To investigate the feasibility and safety of an innovative program of home-based RPSS combined with motor training and to collect preliminary data on the efficacy of this program to enhance hand motor function in patients in the chronic phase after stroke.
Twenty patients were randomized to either active or sham RPSS associated with daily motor training performed at home over 4 consecutive weeks. All the patients were able to perform tasks of the Jebsen-Taylor Test (JTT). The primary outcome measures were feasibility, evaluated by self-reported compliance with the intervention, and safety (adverse events). Secondary outcomes comprised improvements in hand function in the JTT after end of treatment and after a 4-month follow-up period.
There were no relevant adverse events. Compliance with RPSS and motor training was significantly greater in the active group than in the sham group. Upper extremity performance improved significantly more in the active group compared with the sham group at the end of treatment. This difference remained significant 4 months later, even when differences in compliance with motor training were considered.
Home-based active RPSS associated with motor training was feasible, was safe, and led to long-lasting enhancement of paretic arm performance in the chronic phase after stroke for those who can perform the JTT. These results point to the need for an efficacy trial.
以重复外周神经刺激（RPSS）形式进行躯体感觉刺激是改善慢性中风患者上肢运动功能的一种很有前途的策略。基于家庭的 RPSS 可能是基于医院的 RPSS 的替代方案。
研究家庭为基础的 RPSS 联合运动训练的可行性和安全性，并收集该方案在增强中风后慢性期患者手部运动功能方面的初步疗效数据。
20 名患者被随机分配到主动或假 RPSS 组，两组均在家中接受为期 4 周的每日运动训练。所有患者都能够完成 Jebsen-Taylor 测试（JTT）的任务。主要观察指标是通过自我报告的干预措施依从性评估的可行性，以及安全性（不良事件）。次要结果包括治疗结束后手功能在 JTT 中的改善以及 4 个月随访期后的改善。
没有相关的不良事件。与假刺激组相比，主动刺激组的 RPSS 和运动训练依从性显著更高。与假刺激组相比，治疗结束时主动刺激组的上肢运动功能明显改善，4 个月后仍保持显著差异，即使考虑到运动训练的依从性差异。
对于那些能够进行 JTT 的患者，家庭为基础的主动 RPSS 联合运动训练是可行的、安全的，并且可以在中风后慢性期持久地提高患肢的运动表现。这些结果表明需要进行疗效试验。
