Functional and corticomotor changes in individuals with tetraplegia following unimanual or bimanual massed practice training with somatosensory stimulation: A pilot study

Larisa R. Hoffman, Edelle C. Field-Fote

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Background and Purpose: In individuals with cervical spinal cord injury (SCI), damage to spinal pathways results in deficits of hand function; maladaptive cortical changes further impair function. Unimanual massed practice (MP) training with somatosensory stimulation (SS) has been shown to improve hand function and increase corticomotor excitability after SCI. However, bimanual training may be more beneficial as these individuals have bilateral impairment. We compared clinical and corticomotor changes associated with unimanual versus bimanual MP training, each combined with SS. Methods: Participants were 13 individuals with chronic tetraplegia who had at least minimal voluntary control of the thenar muscles of 1 hand. The participants were randomly assigned to unimanual MP + SS or bimanual MP + SS. Clinical outcome measures included tests of unimanual (Jebsen Taylor Hand Function Test; JTT) and bimanual hand function (Chedoke Arm and Hand Activity Inventory; CAHAI), sensory function (monofilament test), and pinch grip strength. Neurophysiological outcome measures were corticomotor map area, center of gravity (COG), of the corticomotor map and corticomotor threshold as assessed by transcranial magnetic stimulation. Results: There were no significant differences in outcomes between the unimanual MP + SS versus bimanual MP + SS groups, both groups showed significant improvements in the JTT, CAHAI, and monofilament test. However, trends suggest that the unimanual MP + SS group had greater improvement in the JTT whereas the bimanual MP + SS group had greater improvement on the CAHAI. Functional changes were accompanied by a strong trend toward increased corticomotor map area. Discussion and Conclusion: When combined with SS, both unimanual and bimanual MP training improve hand function and sensation in individuals with tetraplegia. Changes in hand function seem to be associated with increased corticomotor map area.

Original languageEnglish
Pages (from-to)193-201
Number of pages9
JournalJournal of Neurologic Physical Therapy
Volume34
Issue number4
DOIs
StatePublished - Dec 1 2010

Fingerprint

Quadriplegia
Hand
Spinal Cord Injuries
Pinch Strength
Outcome Assessment (Health Care)
Transcranial Magnetic Stimulation
Gravitation
Hand Strength
Arm
Equipment and Supplies
Muscles

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation
  • Clinical Neurology

Cite this

Functional and corticomotor changes in individuals with tetraplegia following unimanual or bimanual massed practice training with somatosensory stimulation : A pilot study. / Hoffman, Larisa R.; Field-Fote, Edelle C.

In: Journal of Neurologic Physical Therapy, Vol. 34, No. 4, 01.12.2010, p. 193-201.

Research output: Contribution to journalArticle

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