Effect of Multisensory Stimulation on Upper Extremity Motor Recovery in Stroke Patient: a Preliminary Testing

Study Overview
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Brief Summary
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Despite the advances in stroke rehabilitation, post-stroke upper extremity impairment is still a major challenge. Increasing evidence can be found supporting stimulation of the afferent receptor enhances neuroplasticity in the brain. Studies have suggested multisensory stimulation could promote motor learning by re-establishing the disrupted sensorimotor loop due to stroke and enhance neuroplasticity. The objective of the study was to examine the effect of multisensory stimulation on upper-extremity motor recovery and self-care function in stroke patients.

Detailed Description
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Stroke patients referred to occupational therapy division of geriatric day hospital will be recruited and randomly assigned to a multisensory therapy group or a conventional training group. The Multisensory therapy group received 12 weeks (two sessions/ week; 90 minutes/session) training. Each session began with 15 minutes of sensory stimulation (cold and vibration), 45 minutes of motor training and 30 minutes of self-care training. The conventional training group included 12 weeks (two sessions/ week; 90 minutes/session) training. Each session included 60 minutes of upper extremity motor practice and 30 minutes of self-care training. Outcome measures included: Brunnstrom's stage, Fugl-Meyer Assessment Scale and Functional Test for the Hemiplegic Upper Extremity were used for upper limb motor control and function; and Manual muscle testing was used for muscle strength. The modified Barthel Index was used for self-care performance

Conditions
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Stroke

Intervention / Treatment
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* Other: Multisensory therapy
* Other: Conventional training


Participation Criteria
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Eligibility Criteria
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Inclusion criteria: First-time ischemic or hemorrhagic stroke; Stroke onset > 4 weeks and < 6 months Single lesion Upper extremity motor deficit No severe cognitive impairment and able to follow verbal instructions. Exclusion Criteria: Skin conditions/ injuries over the stimulation application areas Contraindication for cold or vibration application Speech disorder or global aphasia Musculoskeletal or cardiac disorders Other neurological conditions History of diabetes or sensory impairment attributable to peripheral vascular disease or neuropathy

Ages Eligible for Study
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Minimum Age: 50 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: This was a quasi-randomized-controlled pilot. Participants were randomly allocated by admission sequence to a multisensory therapy group or a conventional training group
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Multisensory therapy group<br>The Multisensory therapy (MT) group received a 12-weeks (two sessions/ week; 90 minutes/session) training conducted by an occupational therapist. Each session began with 15 minutes of sensory stimulation (cold and vibration), 45 minutes of motor training and 30 minutes of self-care training. | Other: Multisensory therapy<br>* Sensory stimulation, motor training and ADL training<br>|
| Active Comparator: Conventional training group<br>The conventional training (CT) group included 12 weeks (two sessions/ week; 90 minutes/session) training conducted by an occupational therapist. Each session included 60 minutes of upper extremity motor practice (same as in MT group) and 30 minutes of self-care training (same as in MT group). | Other: Conventional training<br>* Motor training and ADL training<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from baseline Fugl-Meyer Assessment of Motor Recovery at 3 months | The Fugl-Meyer Assessment was used to assess the progress in synergistic and voluntary movement at baseline and post intervention. | Baseline and post intervention at week 12 | 
| Change from baseline Functional Test for the Hemiplegic Upper Extremity at 3 months | The Functional Test for the Hemiplegic Upper Extremity was used to evaluate the recovery of the hemiplegic upper extremity functions at baseline and post intervention. | Baseline and post intervention at week 12 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from baseline Modified Barthel Index at 3 months | The Modified Barthel Index was used to measure functional performance in basic activities of daily living at baseline and post intervention. | Baseline and post intervention at week 12 | 
| Change from baseline Manual Muscle testing at 3 months | Manual muscle testing (MMT) was used for the evaluation of the motor recovery and strength of upper extremity muscle groups at baseline and post intervention. | Baseline and post intervention at week 12 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Multisensory stimulation; motor recovery