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的疗法，以增加肌肉力量并减少慢性中风患者的手运动障碍。 中风的长期运动障碍没有普遍接受的治疗方法。 手运动功能显着影响中风患者的独立性。体感输入会影响运动皮层的活动，这是足够的运动性能和运动学习所必需的。我们已经表明，即使在没有训练的情况下，将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措施，即使在慢性卒中患者的弱手的弱手应用于慢性卒中患者的弱手时，也会改善手部肌肉力量。中度至重度残疾患者无法训练。 我们将对中度至严重的手部残疾患者的电动神经刺激和运动训练的影响与单独的运动训练进行比较，而没有有效的替代治疗。 我们期望生成有关刺激会增强训练影响的假设的初步数据。 我们将评估患者对研究方案的遵守情况，还将收集有关生物和社会/环境因素的试点数据，这些数据可能影响巴西人口中对康复干预的反应。 将评估年龄，神经生理测量的影响，将评估皮质运动功能，家庭支持和社会状况的影响。确定哪些因素是对治疗的反应是很重要的，因为如果有这样的知识，则有可能适应疗法并指导健康政策以针对这些因素。 该建议将提供神经生理和神经康复研究的培训。我们将建立研究能力，并为未来的研究建立合作：电刺激和训练在改善手动强度和减少慢性中风患者运动障碍方面的有效性；对康复治疗的反应预后因素。 这项研究将在神经病学系的全部支持下在参考大学医院进行，并将为机构卓越做出贡献。 这项研究旨在为没有普遍接受的治疗方法制定一种新颖的康复策略，以针对发展中国家的现实生活。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。结果对于中风的残疾代表了对医疗保健的挑战，结果将非常有价值。

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