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Motor and sensory effects of ipsilesional upper extremity hypothermia and contralesional sensory training for chronic stroke patients.

Abstract：

UNLABELLED:As hypothermia by immersion can reduce the sensory nerve conduction velocity, this study hypothesized that the reduction of sensory input to the ipsilesional upper extremity (UE) using cryotherapy would reduce the inhibitory activity of the contralesional hemisphere in chronic stroke subjects. OBJECTIVE:In this study, hypothermia was applied by immersing the ipsilesional UE in association with sensory training of the contralesional UE of stroke patients to assess the immediate (e.g. sensorimotor function, hemodynamics, and levels of comfort) and long-term (sensory and motor performances of the UEs) effects. METHODS:The sample included 27 stroke patients allocated into group 1 (n = 14), which received conventional physiotherapy for the affected UE, and group 2 (n = 13), which underwent 10 sessions of immersion hypothermia of the ipsilesional wrist and hand. Assessments were performed pre- and post-treatment and at follow-up using esthesiometry, the Fugl-Meyer Assessment (FMA), the Nottingham Sensory Assessment, functional tests, tactile and weight discrimination, motor sequence, level of comfort, and hemodynamic parameters. RESULTS:The immediate effects of hypothermia using immersion of the ipsilesional UE in association with sensory training of the contralesional UE were hemodynamic stability during and after hypothermia, the absence of sensory abnormalities in the contralesional UE, hypoesthesia in the ipsilesional extremity (dermatomes C6 and C8) (P < 0.05), the maintenance of acceptable levels of comfort, and good patient compliance to the technique. The long-term effects included significant increases in scores on tests performed without functional vision, in scores on blindfolded functional tests, and in tactile localization and joint position sense for the contralesional hand in group 2 as well as the maintenance of these gains at long-term follow-up (5 weeks). Improvement was also found in the tactile function of the C6 and C7 dermatomes of the contralesional hand (P < 0.05). CONCLUSIONS:The use of immersion hypothermia on the ipsilesional UE in association with sensory training of the contralesional UE improved motor function and sensitivity in the contralesional UE of individuals with chronic stroke. Immersion hypothermia of the ipsilesional UE in chronic stroke patients is a safe, practical, inexpensive, and easily applied technique.

journal_name

Top Stroke Rehabil

journal_title

Topics in stroke rehabilitation

authors

Lima NM,Menegatti KC,Yu É,Sacomoto NY,Oberg TD,Honorato DC

doi

10.1179/1074935714Z.0000000023

subject

Has Abstract

pub_date

2015-02-01 00:00:00

pages

44-55

issue

eissn

1074-9357

issn

1945-5119

journal_volume

pub_type

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Motor and sensory effects of ipsilesional upper extremity hypothermia and contralesional sensory training for chronic stroke patients.