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Phys Ther. 2019 Jan 28. doi: 10.1093/ptj/pzy143. [Epub ahead of print]

TheraBracelet Stimulation During Task-Practice Therapy to Improve Upper Extremity Function After Stroke: A Pilot Randomized Controlled Study.

Author information

1
Division of Occupation Therapy, Department of Health Professions, Department of Health Sciences and Research, Medical University of South Carolina, 151B Rutledge Ave, Charleston, SC 29425 (USA).
2
Department of Health Sciences and Research, Medical University of South Carolina.
3
Department of Neurology, Medical University of South Carolina.
4
Department of Public Health Sciences, Medical University of South Carolina.
5
Department of Health Professions, Medical University of South Carolina.
6
Division of Occupational Therapy, Medical University of South Carolina.
7
College of Health Professions, Medical University of South Carolina.

Abstract

Background:

Peripheral sensory stimulation has been used in conjunction with upper extremity movement therapy to increase therapy-induced motor gains in patients with stroke. The limitation is that existing sensory stimulation methods typically interfere with natural hand tasks and thus are administered prior to therapy, requiring patients' time commitment. To address this limitation, we have developed TheraBracelet. TheraBracelet is a novel stimulation method that provides subthreshold (ie, imperceptible) vibratory stimulation to the wrist and thus can be used during hand tasks/therapy without interfering with natural hand tasks.

Objective:

The objective was to determine the feasibility of using TheraBracelet during therapy to augment motor recovery after stroke.

Design:

The design was a triple-blinded pilot, randomized, controlled trial.

Methods:

Twelve chronic stroke survivors were assigned to the treatment or control group. All subjects completed 3 2-hour task practice therapy sessions per week for 2 weeks. Both groups wore a small vibrator on the paretic wrist, which was turned on to provide TheraBracelet stimulation for the treatment group and turned off for the control group to provide sham stimulation. Outcome measures (Box and Block [BBT] and Wolf Motor Function [WMFT] Tests) were obtained at baseline, 6 days after therapy, and at follow-up 19 days after therapy.

Results:

The intervention was feasible with no adverse events. The treatment group significantly improved their BBT scores after therapy and at follow-up compared to baseline, while the control group did not. For WMFT, the group by time interaction was short of achieving significance. Large effect sizes were obtained (BBT d = 1.43, WMFT d = 0.87). No indication of desensitization to TheraBracelet stimulation was observed.

Limitations:

The limitation was a small sample size.

Conclusions:

TheraBracelet may be a promising therapy adjuvant for upper extremity recovery after stroke.

PMID:
30690609
DOI:
10.1093/ptj/pzy143

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