Effects of stochastic resonance stimulation on manual function in children with hemiplegic cerebral palsy: A pilot clinical trial.

Autor: Lynn J; Occupational Therapist: Children's Hospital of Richmond at VCU, Richmond, Virginia, USA., Wolf A; Occupational Therapist: Children's Hospital of Richmond at VCU, Richmond, Virginia, USA., Bridges T; Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University Health Systems, Richmond, Virginia, USA., Pottanat Z; Department of Pediatrics, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA., Spivey S; Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University Health Systems, Richmond, Virginia, USA., Rolin O; Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University Health Systems, Children's Hospital of Richmond, Richmond, Virginia, USA.
Jazyk: angličtina
Zdroj: PM & R : the journal of injury, function, and rehabilitation [PM R] 2023 Mar; Vol. 15 (3), pp. 302-313. Date of Electronic Publication: 2022 Apr 08.
DOI: 10.1002/pmrj.12788
Abstrakt: Objective: To investigate the effect of stochastic resonance stimulation (SRS) on manual abilities in children with hemiplegic cerebral palsy.
Design: This pilot study is a randomized, sham-controlled, one-period, crossover trial.
Setting: A neuroscience clinic with specialty therapy programs at an urban, university-based children's hospital.
Participants: Sixteen children ages 3 to 16 years who were diagnosed with hemiplegic cerebral palsy and had hand Manual Abilities Classification scale score of I to III with sufficient cognitive abilities to follow instructions.
Interventions: Children donned wrist and arm bands that delivered SRS via embedded piezoelectric actuators in two randomly assigned conditions: sham (devices powered off) and subthreshold stimulation (SBT-SRS). Following the randomized protocol, a subset of participants also completed an open-label, above-threshold stimulation (AT-SRS) condition. Children carried out the same uni-manual and bimanual tasks during the randomized and open-label protocols; all data were collected in a single session.
Main Outcome Measure(s): Box and Blocks (B&B) test, a uni-manual function test, and the Shriners Hospital Upper Extremity Evaluation (SHUEE). The SHUEE was video recorded and scored by two raters who were blinded to the experimental condition.
Results: Thirteen children completed the B&B task and 14 children completed the SHUEE. Children in the SBT-SRS condition relative to sham condition moved an average of 1.8 more blocks in 1 minute (p = .08); scored an average of 3 points higher on SHUEE spontaneous functional analysis (p < .002); and scored an average of 2.7 points higher on SHUEE dynamic positional analysis (p = .20). In the open-label protocol, children in the AT-SRS condition relative to sham moved 3.9 more blocks than in the sham condition (n = 8, p < .001); scored an average of 4.5 points higher on SHUEE spontaneous functional analysis (n = 6, p = .08); and scored an average of 10.5 points higher on SHUEE dynamic positional analysis (n = 6, p = .01).
Conclusion(s): In this pilot study, we found preliminary evidence that children with hemiplegic cerebral palsy demonstrated improved uni-manual abilities and increased function of the impaired hand on bimanual tasks when receiving a single session of SBT-SRS. Preliminary evidence also suggests that some children with hemiplegic cerebral palsy may improve more when receiving a single session of AT-SRS. Future research using larger, controlled studies should evaluate the optimal intensity, duration, and long-term effect of SRS for improving impaired manual abilities.
(© 2022 The Authors. PM&R published by Wiley Periodicals LLC on behalf of American Academy of Physical Medicine and Rehabilitation.)
Databáze: MEDLINE
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