TY - JOUR
T1 - Massed practice versus massed practice with stimulation
T2 - Effects on upper extremity function and cortical plasticity in individuals with incomplete cervical spinal cord injury
AU - Beekhuizen, Kristina S.
AU - Field-Fote, Edelle C.
PY - 2005/3
Y1 - 2005/3
N2 - Objective. To determine the effect of massed practice (MP) versus massed practice combined with somatosensory stimulation (MP+SS) on cortical plasticity and function in persons with incomplete tetraplegia. Methods. Ten subjects were assigned to either MP or MP+SS. Median nerve stimulation (500 ms train, 10 Hz, 1 ms pulse duration) was delivered at the intensity eliciting a motor threshold response. Training sessions were 5 d/week for 3 weeks at 2 h/session. Outcome measures included 1) motor-evoked potentials (MEPs) elicited via transcranial magnetic stimulation (TMS), motor threshold (MT) and MEP amplitude at 1.2x MT; 2) maximal pinch grip force; 3) Wolf Motor Function Test (WMFT) and Jebsen Hand Function Test. Results. The MP+SS group demonstrated significant improvements (P < 0.05) in pinch grip strength (190%), WMFT scores (52%), and Jebsen test scores (33%), whereas the MP group demonstrated significant improvement (P < 0.05) only in Jebsen test scores (11%). No significant changes were detected in cortical excitability in the MP+SS or MP group. Conclusions. The findings of this preliminary study suggest that MP+SS results in greater increases in pinch strength and timed functional test scores than MP. Optimal stimulation paradigms and training methods are needed to further test this strategy.
AB - Objective. To determine the effect of massed practice (MP) versus massed practice combined with somatosensory stimulation (MP+SS) on cortical plasticity and function in persons with incomplete tetraplegia. Methods. Ten subjects were assigned to either MP or MP+SS. Median nerve stimulation (500 ms train, 10 Hz, 1 ms pulse duration) was delivered at the intensity eliciting a motor threshold response. Training sessions were 5 d/week for 3 weeks at 2 h/session. Outcome measures included 1) motor-evoked potentials (MEPs) elicited via transcranial magnetic stimulation (TMS), motor threshold (MT) and MEP amplitude at 1.2x MT; 2) maximal pinch grip force; 3) Wolf Motor Function Test (WMFT) and Jebsen Hand Function Test. Results. The MP+SS group demonstrated significant improvements (P < 0.05) in pinch grip strength (190%), WMFT scores (52%), and Jebsen test scores (33%), whereas the MP group demonstrated significant improvement (P < 0.05) only in Jebsen test scores (11%). No significant changes were detected in cortical excitability in the MP+SS or MP group. Conclusions. The findings of this preliminary study suggest that MP+SS results in greater increases in pinch strength and timed functional test scores than MP. Optimal stimulation paradigms and training methods are needed to further test this strategy.
KW - Constraint-induced therapy
KW - Electrical stimulation
KW - Exercise
KW - Hand function
KW - Rehabilitation
KW - SCI
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U2 - 10.1177/1545968305274517
DO - 10.1177/1545968305274517
M3 - Article
C2 - 15673842
AN - SCOPUS:13844314801
VL - 19
SP - 33
EP - 45
JO - Journal of Neurologic Rehabilitation
JF - Journal of Neurologic Rehabilitation
SN - 1545-9683
IS - 1
ER -