Article

OBJECTIVE: To evaluate the effectiveness of thermal stimulation accompanied by
either active or passive movement added to standard rehabilitation in
facilitating motor and balance function of the paretic leg of acute stroke.
DESIGN: Pilot, observer-blinded, randomized clinical trial. SETTING: Department
of rehabilitation medicine in a general hospital. SUBJECTS: Thirty-six patients
were enrolled within four weeks of the onset of a stroke causing moderate to
severe leg paresis (Brunnstrom stage </=III). INTERVENTIONS: Patients were
randomly assigned to thermal (standard rehabilitation plus approximately 30-40
minutes of thermal stimulation therapy daily for six weeks) and control (standard
rehabilitation only) groups. MAIN MEASURES: Fugl-Meyer lower extremity score,
Medical Research Council scale for lower extremity, Modified Motor Assessment
Scale, Postural Assessment Scale for Stroke Patients Trunk Control, Berg Balance
Scale, Functional Ambulation Classification and Modified Ashworth Scale. RESULTS:
Patients in the thermal group experienced significantly better median scores for
Fugl-Meyer lower extremity (14.0; interquartile range, 10.5-15.5), Medical
Research Council scale for lower extremity (6.0; 4.0-7.0), Modified Motor
Assessment Scale (16.0; 12.5-18.5), Berg Balance Scale (28.0; 20.5-33.5), and
Functional Ambulation Classification (2.0; 2.0-2.0) (all P < 0.05). The thermal
group also had more independent walkers (15/17; 88.2%) than the control group
(9/16; 56.3%) after six weeks (P = 0.06). No adverse effect occurred.
CONCLUSIONS: Thermal stimulation accompanied by either manual facilitation or
encouragement for active participation of the paretic lower limb may be an
effective promising supplementary treatment for the early-phase rehabilitation of
moderate to severe stroke that warrants additional study.

Langue : ANGLAIS