Effects of Sensory Cueing on Voluntary Arm Use for Patients With Chronic Stroke: A Preliminary Study

Fong KN, Lo PC, Yu YS, Cheuk CK, Tsang TH, Po AS, Chan CC. Effects of sensory cueing on voluntary arm use for patients with chronic stroke: a preliminary study. Arch Phys Med Rehabil 2011;92:15-23. Objective: To investigate the effect of a 2-week program of sensory cueing in which vibration induces the use of the paretic upper extremity in participants with chronic stroke in the community. Design: A single-group longitudinal study. Setting: Self-help organizations. Participants: A convenience sample of 16 community residents (N=16) with chronic unilateral stroke and mild to moderate upper-extremity impairment stratified by the severity of their paretic arm function, measured by using the Functional Test for the Hemiplegic Upper Extremity (FTHUE). Interventions: Participants engaged in repetitive upper-extremity task practice for 2 weeks while wearing an ambulatory sensory cueing device on their affected hand for 3 hours a day. Main Outcome Measures: Evaluations were conducted on the 3 occasions of pretest (1 day before training), posttest (immediately after training), and follow-up test (2 weeks after training) by using the following behavioral measures of paretic upper-extremity performance: the Action Research Arm Test (ARAT), the Box and Block Test, the Fugl-Meyer Assessment (FMA), the FTHUE, power and pinch grips, the Motor Activity Log assessment of arm use, and kinematic data obtained from the device. Results: Significant differences were found in ARAT and FMA scores among the pretest, posttest, and follow-up evaluations. The lower functioning group achieved a more significant increase in overall upper-extremity score than in the hand score for the FMA. Conclusion: A combination of sensory cueing and movement-based strategies is useful and feasible in improving paretic upper-extremity performance in participants with chronic stroke; however, additional studies with a larger sample size and longer treatment period in a randomized controlled trial would be beneficial.