To stimulate or not to stimulate? A rapid systematic review of repetitive sensory stimulation for the upper-limb followi
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REVIEW
Open Access
To stimulate or not to stimulate? A rapid systematic review of repetitive sensory stimulation for the upper-limb following stroke Rachel C. Stockley1* , Kerry Hanna2 and Louise Connell3
Abstract Background: Repetitive sensory stimulation (RSS) is a therapeutic approach which involves repeated electrical stimulation of the skin’s surface to improve function. This rapid systematic review aimed to describe the current evidence for repetitive sensory stimulation (RSS) in rehabilitation of the upper-limb for people who have had a stroke. Main text: Methods: Relevant studies were identified in a systematic search of electronic databases and handsearching in February 2020. The findings of included studies were synthesized to describe: the safety of RSS, in whom and when after stroke it has been used, the doses used and its effectiveness. Results: Eight studies were included. No serious adverse events were reported. The majority of studies used RSS in participants with mild or moderate impairments and in the chronic stage after stroke. Four studies used RSS in a single treatment session, reporting significant improvements in strength and hand function. Findings from longitudinal studies showed few significant differences between control and experimental groups. Meta-analysis was not possible due to the heterogeneity of included studies. Conclusions: This review suggests that there is insufficient evidence to support the use of RSS for the upper-limb after stroke in clinical practice. However, this review highlights several clear research priorities including establishing the mechanism and in whom RSS may work, its safety and optimal treatment parameters to improve function of the upper-limb after stroke. Keywords: Sensory stimulation, Upper limb, Stroke, Nerve stimulation, Rehabilitation
Background Upper-limb impairments are the most common deficit after stroke and are reported by at least 70% of people after stroke [1]. Recovery of the upper-limb after stroke is problematic; whilst two-thirds of people after stroke go on to walk independently, less than 20% recover full upper* Correspondence: [email protected] 1 Stroke Research Team, School of Nursing, Faculty of Health and Wellbeing, University of Central Lancashire, Preston PR1 2HE, UK Full list of author information is available at the end of the article
limb function and over half have not regained even basic functions of the upper-limb after several years [1, 2]. Identifying efficacious treatments for the upper-limb is vital to improve function and well-being after stroke [3]. The use of electrical stimulation for rehabilitation has been recognized as a promising therapy [4, 5] and has featured in clinical stroke guidelines [6]. Repetitive sensory stimulation (RSS) is a form of electrical simulation which aims to promote improvements in motor function [7]. It is often delivered to the skin via
© The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, shar
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