Effectiveness of Thermal Stimulation for the Moderately to Severely Paretic Leg After Stroke: Serial Changes at One-Year Follow-Up

Liang C-C, Hsieh T-C, Lin C-H, Wei Y-C, Hsiao J, Chen J-C. Effectiveness of thermal stimulation for the moderately to severely paretic leg after stroke: serial changes at one-year follow-up.ObjectiveTo evaluate the serial changes of long-term effects of thermal stimulation (TS) on acute stroke patients.DesignA prospective study with follow-up at 3, 6, and 12 months after TS to assess motor and balance function of the paretic leg of acute stroke patients.SettingA general hospital rehabilitation department.ParticipantsPoststroke patients (N=30) with moderate to severe impairment of leg function.InterventionsIn addition to receiving standard rehabilitation, eligible patients were randomly assigned to a TS group (5 thermal stimulations per week for 6wk) or a control group (3 consultations per week for 6wk).Main Outcome MeasuresFugl-Meyer lower extremity score, Medical Research Council Scale for the Lower Extremity, Berg Balance Scale, Modified Motor Assessment Scale, Functional Ambulation Classification, and Barthel Index were administered at baseline, after 4 and 6 weeks of treatment, and at the 3-, 6-, and 12-month follow-up.ResultsNo significant differences were found between the 2 groups at baseline. After TS, the Fugl-Meyer lower extremity score, Medical Research Council Scale for the Lower Extremity, Modified Motor Assessment Scale, and Functional Ambulation Classification were significantly better in the TS group, and the effects persisted for 3 months (P<.05). Significant differences were found between the 2 groups for the Berg Balance Scale and Barthel Index only at the 3-month follow-up (P<.05). However, all the effects except for the Fugl-Meyer lower extremity score had disappeared at the 6-month follow-up (P>.05).ConclusionsThe long-term benefits of TS for patients with acute stroke may be sustained for 3 months but disappear by the 6-month and 1-year follow-up.