Objective: To evaluate the efficacy of intermittent pneumatic compression (IPC) in treating sensory impairments in the hemiplegic upper limb in stroke patients.
Design: Twenty-three stroke patients were enrolled in a randomized, controlled preliminary trial that compared the application of intermittent pneumatic compression with a passive treatment strategy.
Setting: Four Belgian day centers for treatment of neurological disabilities. Four acute and rehabilitation care wards specialized in neurological treatment.
Subjects: Twenty-three stroke patients.
Interventions: The experimental group (n = 11) received standard physiotherapy combined with intermittent pneumatic compression treatment (10 cycles of 3 minutes with a peak of 40 mmHg) for their hemiplegic upper limb. The control group (n = 12) received supplementary to their conventional physiotherapy a placebo treatment, namely sham short-wave therapy on the hemiplegic shoulder for 30 minutes.
Main outcome measures: Sensory impairments were clinically assessed at three occasions over a period of four weeks using the Nottingham Sensory Assessment scale.
Results: Both groups improved in somatosensation over time, but the experimental group improved more than the control group (p = 0.036) or 81.1% improvement versus 30.9%.
Conclusions: The use of intermittent pneumatic compression in the rehabilitation of stroke patients may be of clinical importance for the restoration of sensory function.
Get full access to this article
View all access options for this article.
References
1.
Carey LM. Somatosensory loss after stroke. Crit Rev Phys Rehabil Med1995; 7:51–91.
2.
Dannenbaum RM, Jones LA. The assessment and treatment of patients who have sensory loss following cortical lesions. J Hand Ther1993; 6:130–138.
3.
Yekutiel M, Guttman E. A controlled trial of the retraining of the sensory function of the hand in stroke patients. J Neurol Neurosurg Psychiatry1993; 56:241–244.
4.
Carey LM, Matyas TA, Oke LE. Sensory loss in stroke patients:effective training of tactile and proprioceptive discrimination. Arch Phys Med Rehabil1993; 74:602–611.
5.
Kwakkel G, Wagenaar RC, Kollen BJ, Lankhorst GJ. Predicting disability in stroke – a critical review of the literature. Age Ageing1996; 25:479–489.
6.
Feys HM, De Weerdt WJ, Selz BE et al. Effect of a therapeutic intervention for the hemiplegic upper limb in the acute phase after stroke. A single-blind, randomized, controlled multicenter trial. Stroke1998; 29:785–792.
7.
Johnstone M. Therapy for stroke:building on experience. Edinburgh:Churchill Livingstone, 1991.
8.
Johnstone M. The use of pressure splints. In:Restoration of normal movement after stroke. Edinburgh:Churchill Livingstone, 1995.
9.
Lincoln NB, Jackson JM, Waters GR, Adams SA, Hodgson P. The unreliability of sensory assessments. Clin Rehabil1991; 5:273–282.
10.
Lincoln NB, Jackson JM, Adams SA. Reliability and revision of the Nottingham Sensory Assessment for stroke patients. Physiotherapy1998; 84:358–365.
11.
Davies PM. Steps to follow – a guide to the treatment of adult hemiplegia. Berlin:Springer-Verlag, 1985.
12.
Davies PM. Right in the middle – selective trunk activity in the treatment of adult hemiplegia. Berlin:Springer-Verlag, 1990.
13.
Davies PM. Steps to follow – the comprehensive treatment of patients with hemiplegia, second edition. Berlin:Springer-Verlag, 2000.
14.
Sanford J, Moreland J, Swanson LR, Stratford PW, Gowland C. Reliability of the Fugl-Meyer Assessment for testing motor performance in patients following stroke. Phys Ther1993; 73:447–454.
15.
Fugl-Meyer AR, Jaasko L, Leyman I, Olsson S, Steglind S. The post-stroke hemiplegic patient:a method for evaluation of physical performance. Scand J Rehabil Med1975; 7:13–31.
16.
Fugl-Meyer AR. Post-stroke hemiplegia:assessment of physical properties. Scand J Rehabil Med Suppl1980; 7:85–93.
17.
Bohannon RW, Smith MB. Interrater reliability of a Modified Ashworth Scale of muscle spasticity. Phys Ther1987; 67:206–207.
18.
Scott J, Huskinsson EC. Graphic representation of pain. Pain1976; 2:175–184.
