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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
    Affiliations
    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
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  • Ta-Shen Kuan
    Affiliations
    Department of Physical Medicine and Rehabilitation, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan
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  • Ching-Liang Tsai
    Affiliations
    Department of Physical Medicine and Rehabilitation, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan
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  • Po-Ting Wu
    Affiliations
    Department of Orthopedics, College of Medicine, National Cheng Kung University, Tainan
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  • Yao-Lung Kuo
    Affiliations
    Department of Surgery, College of Medicine, National Cheng Kung University, College of Medicine, Tainan
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  • Author Footnotes
    ∗ Su and Kuo contributed equally to this work.
    Fong-Chin Su
    Footnotes
    ∗ Su and Kuo contributed equally to this work.
    Affiliations
    Department of Biomedical Engineering, College of Engineering, National Cheng Kung University, Tainan

    Medical Device Innovation Center, National Cheng Kung University, Tainan, Taiwan
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  • Author Footnotes
    ∗ Su and Kuo contributed equally to this work.
    Li-Chieh Kuo
    Correspondence
    Corresponding author Li-Chieh Kuo, PhD, Department of Occupational Therapy, College of Medicine, National Cheng Kung University, No. 1, University Rd, Tainan City 701, Taiwan.
    Footnotes
    ∗ Su and Kuo contributed equally to this work.
    Affiliations
    Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan

    Medical Device Innovation Center, National Cheng Kung University, Tainan, Taiwan
    Search for articles by this author
  • Author Footnotes
    ∗ Su and Kuo contributed equally to this work.
Published:December 02, 2020DOI:https://doi.org/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.

      Keywords

      List of abbreviations:

      BBT (box and block test), FMA (Fugl-Meyer Assessment), MAL (Motor Activity Log), MAS (Modified Ashworth Scale), QOM (quality of movement), SWM (Semmes-Weinstein monofilament), VTS (vibrotactile therapy system)
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