Abstract
Objective
To explore the effects of Mobilization and Tactile Stimulation (MTS) and patterns
of recovery in chronic stroke (>12mo) when upper limb (UL) “performance” has reached
a clear plateau.
Design
Replicated single-system experimental study with 8 single cases using A-B-A design
(baseline-intervention-withdrawal phases); length of baseline randomly determined;
intervention phase involved 6 weeks of daily MTS to the contralesional UL.
Setting
Community setting, within participants' place of residence.
Participants
Individual stroke survivors (N=8; male-to-female ratio, 3:1; age range, 49–76y; 4
with left hemiplegia, 4 with right hemiplegia) discharged from ongoing therapy, more
than 1 year post stroke (range, 14–48mo). Clinical presentations were varied across
the sample.
Interventions
Participants received up to 1 hour of daily (Monday to Friday) treatment with MTS
to the UL for 6 weeks during the intervention (B) phase.
Main Outcome Measures
Motor function (Action Research Arm Test [ARAT]) and motor impairment (Motricity Index
[MI] arm section) of the UL.
Results
UL performance was stable during baseline for all participants. On visual analysis,
improvements in motor impairment were seen in all participants, and clinically significant
improvements in motor function were seen in 4 of 8 participants during the intervention
phase. Latency between onset of intervention and improvement ranged from 5 to 31 days
(ARAT) and from 0 to 28 days (MI). Improvements in performance were maintained on
withdrawal of the intervention. Randomization tests were not significant.
Conclusions
MTS appears to improve UL motor impairment and functional activity many months, even
years, after stroke onset. Improvement can be immediate, but more often there is latency
between the start of intervention and improvement; recovery can be distal to proximal.
Keywords
List of abbreviations:
ARAT (Action Research Arm Test), MI (Motricity Index), MRC (Medical Research Council), MTS (Mobilization and Tactile Stimulation), UK (United Kingdom), UL (upper limb)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: November 30, 2012
Footnotes
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
Identification
Copyright
© 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
