Abstract TP153: Repetitive Peripheral Sensory Stimulation in Stroke: a Systematic Review and Meta-Analysis

Abstract

Background: Enhancement of sensory input in the form of repetitive peripheral sensory stimulation (RPSS) can enhance excitability of the motor cortex and upper limb performance. Objective: To perform a systematic review and meta-analysis of effects of RPSS compared to control stimulation on improvement of motor impairments in the upper limb of subjects with stroke. Methods: We searched studies published between 1948 until July, 2016 and selected eight studies that applied a specific paradigm of stimulation (trains of 1 millisecond pulses at 10Hz delivered at 1 Hz). Continuous data were analyzed with pooled means of standard deviations of results of active versus control interventions with the Cohen and Hedges formulas. Adverse events were also assessed. Results: There was significant heterogeneity when data from all eight studies that included subjects at early (n=3) or chronic (n=5) stages after stroke were included, but not when only data from studies in the chronic phase were analyzed. There was a statistically significant beneficial effect of RPSS on motor performance in subjects in the chronic phase with an overall small effect size (standard mean difference between active and control RPSS, 0.45; 95% confidence interval, 0.07, 0.84). When data from the three studies that included subjects at an early stage after stroke were added, the effect was no longer statistically significant. No serious adverse events were reported. Conclusions: RPSS is a safe intervention with potential to become an adjuvant tool for upper extremity paresis rehabilitation in subjects with stroke in the chronic phase.