PubMed:28610960 JSONTXT

{"project":"PubMed_Structured_Abstracts","denotations":[{"id":"T1","span":{"begin":198,"end":487},"obj":"BACKGROUND"},{"id":"T2","span":{"begin":499,"end":649},"obj":"OBJECTIVE"},{"id":"T3","span":{"begin":658,"end":772},"obj":"DESIGN"},{"id":"T4","span":{"begin":782,"end":840},"obj":"SETTING"},{"id":"T5","span":{"begin":855,"end":1002},"obj":"PARTICIPANTS"},{"id":"T6","span":{"begin":1017,"end":1483},"obj":"INTERVENTION"},{"id":"T7","span":{"begin":1494,"end":1783},"obj":"OUTCOMES"},{"id":"T8","span":{"begin":1793,"end":2181},"obj":"RESULTS"},{"id":"T9","span":{"begin":2195,"end":2421},"obj":"CONCLUSIONS"},{"id":"T10","span":{"begin":2441,"end":2458},"obj":"LEVEL OF EVIDENCE"}],"text":"No Difference Between Noxious and Innocuous Thermal Stimulation on Motor Recovery of Upper Extremity in Patients With Acute Stroke: A Randomized Controlled Trial With 6-Month Follow-up.\nBACKGROUND: Thermal stimulation (TS) has been developed and incorporated into stroke rehabilitation. However, whether noxious and innocuous TS induce the same effects on motor function recovery after stroke is still unknown. A comparative study of different temperature combination regimens is needed.\nOBJECTIVE: To compare the short- and long-term effectiveness between noxious and innocuous TS on motor recovery of upper extremity in patients with acute stroke.\nDESIGN: Randomized, controlled trial with concealed allocation, intention-to-treat analysis and blinded outcome assessors.\nSETTING: A university hospital rehabilitation department in Taiwan.\nPARTICIPANTS: A total of 79 patients with acute ischemic stroke were recruited. The majority had moderate to severe motor impairment of the upper extremity (UE).\nINTERVENTION: In addition to traditional rehabilitation, the experimental group (n = 39) underwent noxious TS (heat pain 46-47°C/cold pain 7-8°C), and the control group (n = 40) received innocuous TS (heat 40-41°C/cold 20-21°C). TS intervention was applied for 30 minutes once per day and for a total of 20-24 times during hospital stay. A custom-made TS instrument, comprising 2 thermal stimulators and their respective thermal pads constructed in a closed-loop system, was used.\nOUTCOMES: The Fugl-Meyer upper extremity score (the primary outcome), Action Research Arm Test, Motricity Index, Barthel Index, and modified Ashworth scale (the secondary outcomes) were administered by a blinded assessor at baseline, post-12th TS, post-intervention, 1-month, and 6-month follow-ups.\nRESULTS: No significant differences between groups were found on the primary outcome at postintervention and follow-up assessments. At 1-month follow-up, the innocuous group showed a small effect (partial η(2) = 0.02) that was greater than that of the noxious group, but that effect was eliminated at 6 months. Both groups presented significant within-group improvements over time (both P \u003c .001).\nCONCLUSIONS: Combining noxious TS with traditional rehabilitation did not yield better short-term or long-term results than combining innocuous TS with traditional rehabilitation on UE functional recovery for individuals with acute stroke.\nLEVEL OF EVIDENCE: To be determined."}