Nerve Stimulation to Improve Hand Weakness in Stroke

神经刺激可改善中风时的手部无力

• 批准号: 6723449
• 负责人: ADRIANA B CONFORTO
• 金额: $ 8.1万
• 依托单位: UNIVERSITY OF SAO PAULO
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-09-29 至 2009-09-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6723449
• 关键词: Brazil; South American; age difference; clinical research; family structure /dynamics; functional ability; hand; human subject; medical rehabilitation related tag; muscle strength; neuromuscular stimulator; patient oriented research; psychomotor function; rehabilitation; social status; socioenvironment; stroke; therapy compliance; therapy design /development

DESCRIPTION (provided by applicant): This proposal intends to develop a novel therapy to increase muscle strength and decrease hand motor disability in chronic stroke patients. There is no universally accepted treatment for long-term motor disability from stroke. Hand motor function significantly impacts independence of stroke patients. Somatosensory input influences activity in the motor cortex and is required for adequate motor performance and motor learning. We have shown that somatosensory stimulation in the form of electrical nerve stimulation, a straightforward and well-tolerated intervention, results in improvement in hand muscle strength when applied to the weak hand of chronic stroke patients, even in the absence of training. Patients with moderate to severe hand disability cannot train well. We will compare the effects of electrical nerve stimulation and motor training to motor training alone, in patients with moderate to severe hand disability, to whom there is no effective alternative treatment available. We expect to generate preliminary data regarding the hypothesis that the stimulation will enhance the effects of training. We will evaluate patient compliance to the research protocol, and will also collect pilot data regarding biological and social/environmental factors that can influence the response to rehabilitative interventions in a Brazilian population. The influence of age, neurophysiological measurements of corticomotor function, family support and social status will be evaluated. It is important to determine which factors underlie response to treatment because, if such knowledge were available, it would be possible to adapt therapies and guide health policies to target these factors. This proposal will provide training in neurophysiological and neurorehabilitation research. We will build research capacity and develop collaboration for future studies regarding: effectiveness of electrical stimulation and training in improving hand strength and decreasing motor disability in chronic stroke patients; prognostic factors for response to rehabilitation therapy. The research will be conducted in a reference university hospital, with full support from the Neurology Department, and will contribute to institutional excellence. This research intends to develop a novel rehabilitative strategy for a condition for which there is no universally accepted treatment, targeting real-life outcomes in a developing country. If successful, these goals may have a major impact in the way chronic stroke patients are treated. The results will be highly valuable to populations in which disability from stroke represents a challenge to health care.

描述（由申请人提供）：该提案旨在开发一种新型疗法，以增加慢性卒中患者的肌肉力量并减少手部运动障碍。 对于中风造成的长期运动障碍，目前还没有普遍接受的治疗方法。 手运动功能显著影响脑卒中患者的独立性。躯体感觉输入影响运动皮层的活动，并且是足够的运动表现和运动学习所必需的。我们已经证明，以电神经刺激形式的体感刺激，一种直接且耐受性良好的干预，即使在没有训练的情况下，也能改善慢性中风患者的手部肌肉力量。中度至重度手残疾的患者不能很好地训练。 我们将比较电神经刺激和运动训练与单独运动训练对中重度手残疾患者的影响，对这些患者没有有效的替代治疗方法。 我们希望生成关于刺激将增强训练效果的假设的初步数据。 我们将评估患者对研究方案的依从性，并将收集有关生物和社会/环境因素的试点数据，这些因素可能影响巴西人口对康复干预措施的反应。 将评估年龄、皮质运动功能的神经生理学测量、家庭支持和社会地位的影响。必须确定哪些因素是治疗反应的基础，因为如果有这种知识，就有可能调整治疗方法，并指导卫生政策针对这些因素。 该提案将提供神经生理学和神经康复研究方面的培训。我们将建立研究能力，并为未来的研究发展合作：电刺激和训练在改善慢性中风患者手部力量和减少运动障碍方面的有效性;对康复治疗反应的预后因素。 这项研究将在一所参考大学医院进行，得到神经科的全力支持，并将有助于机构的卓越。 这项研究旨在为一种没有普遍接受的治疗方法的疾病制定一种新的康复策略，目标是发展中国家的现实生活结果。如果成功，这些目标可能会对慢性中风患者的治疗方式产生重大影响。这些结果对于中风致残对医疗保健构成挑战的人群将是非常有价值的。

项目成果

Effects of somatosensory stimulation on motor function after subacute stroke.

• DOI: 10.1177/1545968309349946
• 发表时间: 2010-03
• 期刊: Neurorehabilitation and neural repair
• 影响因子: 4.2
• 作者: Conforto AB;Ferreiro KN;Tomasi C;dos Santos RL;Moreira VL;Marie SK;Baltieri SC;Scaff M;Cohen LG
• 通讯作者: Cohen LG

Decreased short-interval intracortical inhibition correlates with better pinch strength in patients with stroke and good motor recovery.

短间隔皮质内抑制的减少与中风患者更好的捏力和良好的运动恢复相关。

• DOI: 10.1016/j.brs.2018.01.030
• 发表时间: 2018
• 期刊: Brain stimulation
• 影响因子: 7.7
• 作者: FerreirodeAndrade,KarinaNocelo;Conforto,AdrianaBastos
• 通讯作者: Conforto,AdrianaBastos