Quadriplegia Research Today is a free monthly online journal that collates and summarizes the latest research about Quadriplegia, including details on quadriplegics, causes, prevention, surgery, treatment.

Sensory stimulation augments the effects of massed practice training in persons with tetraplegia.

Beekhuizen KS, Field-Fote EC

Department of Veterans Affairs Medical Center, Miami, FL, USA.

OBJECTIVE: To compare functional changes and cortical neuroplasticity associated with hand and upper extremity use after massed (repetitive task-oriented practice) training, somatosensory stimulation, massed practice training combined with somatosensory stimulation, or no intervention, in persons with chronic incomplete tetraplegia. DESIGN: Participants were randomly assigned to 1 of 4 groups: massed practice training combined with somatosensory peripheral nerve stimulation (MP+SS), somatosensory peripheral nerve stimulation only (SS), massed practice training only (MP), and no intervention (control). SETTING: University medical school setting. PARTICIPANTS: Twenty-four subjects with chronic incomplete tetraplegia. INTERVENTIONS: Intervention sessions were 2 hours per session, 5 days a week for 3 weeks. Massed practice training consisted of repetitive practice of functional tasks requiring skilled hand and upper-extremity use. Somatosensory stimulation consisted of median nerve stimulation with intensity set below motor threshold. MAIN OUTCOME MEASURES: Pre- and post-testing assessed changes in functional hand use (Jebsen-Taylor Hand Function Test), functional upper-extremity use (Wolf Motor Function Test), pinch grip strength (key pinch force), sensory function (monofilament testing), and changes in cortical excitation (motor evoked potential threshold). RESULTS: The 3 groups showed significant improvements in hand function after training. The MP+SS and SS groups had significant improvements in upper-extremity function and pinch strength compared with the control group, but only the MP+SS group had a significant change in sensory scores compared with the control group. The MP+SS and MP groups had greater change in threshold measures of cortical excitability. CONCLUSIONS: People with chronic incomplete tetraplegia obtain functional benefits from massed practice of task-oriented skills. Somatosensory stimulation appears to be a valuable adjunct to training programs designed to improve hand and upper-extremity function in these subjects.

Published 31 March 2008 in Arch Phys Med Rehabil, 89(4): 602-8.
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Articles on Quadriplegia published 31 March 2008:

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