human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective : The aim of this study was to evaluate the effectiveness of Cognitive Sensory Motor Training Therapy ( Perfetti ’s method ) vis-à-vis conventional occupational therapy in the recovery of arm function after acute stroke . Design : Prospect i ve r and omized controlled trial . Setting : Two rehabilitation centers in Bangkok , Thail and . Subjects : Forty first-time acute stroke patients without severe cognitive or language impairment . Intervention : All subjects were r and omly divided into two groups ; one was treated using Perfetti ’s method and the other using conventional occupational therapy . Each group underwent therapy for 30 minutes , five times a week for four weeks . Main measures : The primary variable was arm function as assessed by the Action Research Arm Test ; secondary variables were the extended Barthel Index and the box and block test score . Results : The intention-to-treat analysis revealed no statistically significant differences between the two groups at the end of treatment for any variable . Conclusions : There was no evidence of a difference between Cognitive Sensory Motor Training Therapy of Perfetti ’s method and conventional occupational therapy with respect to the restoration of h and and arm function after a stroke Background : Left-sided transcutaneous electrical nerve stimulation ( TENS ) increases right hemispheric activity , which may improve the rehabilitative outcome of hemispatial neglect . Objective : To examine the behavioral effect of electrical stimulation of the nerve afferents of the left h and during early neuropsychological rehabilitation of post-stroke patients with hemispatial neglect . Methods : This r and omized , controlled , double-blind study included 29 patients ( enrolled in the experimental or control group ) with left hemispatial neglect after right hemispheric stroke . For 3 weeks , patients received 15 therapeutic sessions involving TENS ( active or sham ) with a mesh glove applied on the entire left h and during the first 30 minutes of a 45-minute conventional visual scanning training ( VST ) .  Signs of hemispatial neglect were assessed using a psychometric test before and after treatment . Results : Univariate analysis of covariance revealed that differences between the control and experimental groups were not significant after treatment ( F(1 , 22 ) = 0.294 , P = 0.593 ) when adjusted for pre-treatment scores and time since stroke onset . This suggested that electrical stimulation failed to mitigate the severity of hemispatial neglect symptoms . Conclusion : Our study did not provide evidence of the effectiveness of  TENS when added to VST during early rehabilitation for patients with post-stroke hemispatial neglect . Other techniques ( applied alone or together ) should be sought to improve recovery in this population Sit-to-st and is a fundamental movement of human being for performing mobility and independent activity . However , Stroke people symptoms experience difficulty in conducting the sit-to-st and due to paralysis and especially ankle spasticity . Recently , transcutaneouselectrical- stimulation ( TENS ) is used to reduce pain but also to manage spasticity . The purpose of this study was to determine ( 1 ) whether TENS would lead to ankle spasticity reduction and ( 2 ) whether sit-to-st and training combined with TENS would improve spasticity , muscle strength and balance ability in stroke patients . Forty-stroke patients were recruited and were r and omly divided into two groups : TENS group ( n=20 ) and sham group ( n=20 ) . All participants underwent 30-sessions of sit-to-st and training ( for 15-min , five-times per week for 6-weeks ) . Prior to each training session , 30-min of TENS over the peroneal nerve was given in TENS group , whereas sham group received non-electrically stimulated TENS for the same amount of time . Composite-Spasticity-Score was used to assess spasticity level of ankle plantar-flexors . Isometric strength in the extensor of hip , knee and ankle were measured by h and held dynamometer . Postural-sway distance was measured using a force platform . The spasticity score in the TENS group ( 2.6±0.8 ) improved significantly greater than the sham group ( 0.7±0.8 , p<0.05 ) . The muscle strength of hip extensor in the TENS group ( 2.7±1.1 kg ) was significantly higher than the sham group ( 1.0±0.8 kg , p<0.05 ) . Significant improvement in postural-sway was observed in the TENS group compared to the sham group ( p<0.05 ) . Thus , sit-to-st and training combined with TENS may be used to improve the spasticity , balance function and muscle strength in stroke patients Background and Purpose — A sensory-based intervention called peripheral nerve stimulation can enhance outcomes of motor training for stroke survivors with mild-to-moderate hemiparesis . Further research is needed to establish whether this paired intervention can have benefit in cases of severe impairment ( almost no active movement ) . Methods — Subjects with chronic , severe poststroke hemiparesis ( n=36 ) were r and omized to receive 10 daily sessions of either active or sham stimulation ( 2 hours ) immediately preceding intensive task-oriented training ( 4 hours ) . Upper extremity movement function was assessed using Fugl – Meyer Assessment ( primary outcome measure ) , Wolf Motor Function Test , and Action Research Arm Test at baseline , immediately post intervention and at 1-month follow-up . Results — Statistically significant difference between groups favored the active stimulation group on Fugl – Meyer at postintervention ( 95 % confidence interval [ CI ] , 1.1–6.9 ; P=0.008 ) and 1-month follow-up ( 95 % CI , 0.6–8.3 ; P=0.025 ) , Wolf Motor Function Test at postintervention ( 95 % CI , −0.21 to −0.02 ; P=0.020 ) , and Action Research Arm Test at postintervention ( 95 % CI , 0.8–7.3 ; P=0.015 ) and 1-month follow-up ( 95 % CI , 0.6–8.4 ; P=0.025 ) . Only the active stimulation condition was associated with ( 1 ) statistically significant within-group benefit on all outcomes at 1-month follow-up and ( 2 ) improvement exceeding minimal detectable change , as well as minimal clinical ly significant difference , on ≥1 outcomes at ≥1 time points after intervention . Conclusions — After stroke , active peripheral nerve stimulation paired with intensive task – oriented training can effect significant improvement in severely impaired upper extremity movement function . Further confirmatory studies that consider a larger group , as well as longer follow-up , are needed . Clinical Trial Registration — URL : http://www . clinical trials.gov . Unique identifier : NCT02633215 OBJECTIVE . We investigated changes in functional arm use after retraining for stroke-related somatosensory loss and identified whether such changes are associated with somatosensory discrimination skills . METHOD . Data were pooled ( N = 80 ) from two r and omized controlled trials of somatosensory retraining . We used the Motor Activity Log to measure perceived amount of arm use in daily activities and the Action Research Arm Test to measure performance capacity . Somatosensory discrimination skills were measured using st and ardized modality-specific measures . RESULTS . Participants ’ arm use improved after somatosensory retraining ( z = −6.80 , p < .01 ) . Change in arm use was weakly associated with somatosensation ( tactile , & bgr ; = 0.31 , p < .01 ; proprioception , & bgr ; = −0.17 , p > .05 ; object recognition , & bgr ; = 0.13 , p < .05 ) . CONCLUSION . Change in daily arm use was related to a small amount of variance in somatosensory outcomes . Stroke survivors  ’ functional arm use can increase after somatosensory retraining , with change varying among survivors Background . Peripheral nerve stimulation may induce cortical adaptations as it improves pinch strength in chronic stroke patients immediately after stimulation . Objective . Test the effects of peripheral sensory stimulation on pinch strength in patients with acute and subacute stroke . Methods . Stroke patients ( N = 20 ) who had onset less than 6 months previously and could voluntarily pinch the thumb to the index finger participated in a r and omized , single-blinded , controlled study . Ten patients received 2 hours of simultaneous electrical stimulation over the median and ulnar nerves at the wrist to the level of appreciating paresthesias ( peripheral sensory stimulation group ) . Ten control patients received stimulation to the level of perception ( sham-control group ) . Pinch strength of the thumb pad to tip and to lateral side of the index finger of the paretic h and and the Action Research Arm test were tested before and immediately after the stimulation . Results . Lateral and tip pinch strength were significantly increased in both groups ( P < .05 ) . Mean ± SD of increased lateral pinch strength of peripheral sensory stimulation and sham-control groups were 1.24 ± 0.54 pounds and 0.20 ± 0.28 pounds , respectively . Mean ± SD of increased tip pinch strength of peripheral sensory stimulation and sham-control groups were 1.00 ± 0.72 pounds and 0.37 ± 0.36 pounds , respectively . Increase pinch strength of the peripheral sensory stimulation group was greater than the sham-control group , with significant difference ( P < .05 ) . The Action Research Arm test was not significantly changed after stimulation in both groups ( P > .05 ) . Conclusion . Peripheral sensory stimulation of the paretic h and may increase pinch strength of acute and subacute stroke patients immediately after stimulation This study aim ed to determine the immediate effects of somatosensory stimulation on h and function in patients with poststroke hemiparesis . Eleven patients with poststroke hemiparesis participated in this study . Four types ( no stimulation , vibration , and light and rough touches ) of somatosensory stimulation were performed r and omly for 4 days applying only one type of somatosensory stimulation each day . The box and block test ( BBT ) , the Jebsen – Taylor h and function test ( JTHFT ) , h and grip strength ( HGS ) , and movement distance and peak velocity of the wrist joint during a forward-reaching task were measured . The BBT and JTHFT scores for no stimulation [ BBT : median ( interquartile range ) , 0.00 ( −1.00 to 1.00 ) and JTHFT : 2.57 ( −0.47 to 4.92 ) ] were significantly different from those for vibration [ BBT : 3.00 ( 2.00–5.00 ) and JTHFT : −16.02 ( −23.06 to −4.31 ) ] , light touch [ BBT : 3.00 ( 1.00–4.00 ) and JTHFT : −5.00 ( −21.20 to −0.94 ) ] , and rough touch [ BBT : 2.00 ( 1.00–4.00 ) and JTHFT : −6.19 ( −18.22 to −3.70 ) ] . The JTHFT score was significantly higher for vibration than that for rough touch ( P<0.05 ) . The increase in HGS was significantly greater for light touch than that for no stimulation ( P<0.05 ) and for vibration than that for light touch ( P<0.05 ) . There were significant differences for the sagittal and coronal planes in movement distance and for the sagittal and horizontal planes in peak velocity during the forward-reaching task ( P<0.05 ) . The findings suggest that somatosensory stimulation may be advantageous to improve the h and function of patients with poststroke hemiparesis , with more favorable effects observed in vibration stimulation Objective : To investigate the feasibility and potential efficacy of ‘ activeTENS ’ ( that is transcutaneous electrical nerve stimulation ( TENS ) during everyday activities ) by assessing the immediate effects on strength , proprioception , balance/falls risk and mobility after stroke . Design : A paired- sample r and omized cross-over trial . Subjects : Twenty-nine mobile chronic stroke survivors with no pre-existing conditions limiting balance or mobility or contra-indications to TENS . Setting : University clinical research facility . Intervention : A single session of ‘ activeTENS ’ delivered via a ‘ sock electrode ’ ( 70–130 Hz , five second cycle ) plus a session of control treatment ( wearing the sock electrode with no stimulation ) , lasting approximately two hours in total . Main Outcomes : Dorsiflexor and plantarflexor strength and proprioception using an isokinetic dyanometer , balance and falls risk ( St and ing Forward Reach Test ) and gait speed ( 10-m walk test ) . Results : All participants tolerated ‘ active TENS ’  . Most parameters improved during stimulation with activeTENS ; balance ( p = 0.009 ) , gait speed ( p = 0.002 ) , plantarflexor strength ( p = 0.008 ) and proprioception of plantarflexion ( p = 0.029 ) , except dorsiflexor strength ( p = 0.194 ) and dorsiflexion proprioception ( p = 0.078 ) . Conclusions : The results provide initial evidence of the potential of ‘ active TENS ’ to benefit physical function after stroke which warrants further phase II trials to develop the intervention . Concerns that stimulation could have a detrimental impact on balance and increase risk of falls were not supported Objective : To evaluate the efficacy of intermittent pneumatic compression ( IPC ) in treating  sensory impairments in the hemiplegic upper limb in stroke patients . Design : Twenty-three stroke patients were enrolled in a r and omized , controlled preliminary trial that compared the application of intermittent pneumatic compression with a passive treatment strategy . Setting : Four Belgian 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective : The aim of this study was to evaluate the effectiveness of Cognitive Sensory Motor Training Therapy ( Perfetti ’s method ) vis-à-vis conventional occupational therapy in the recovery of arm function after acute stroke . Design : Prospect i ve r and omized controlled trial . Setting : Two rehabilitation centers in Bangkok , Thail and . Subjects : Forty first-time acute stroke patients without severe cognitive or language impairment . Intervention : All subjects were r and omly divided into two groups ; one was treated using Perfetti ’s method and the other using conventional occupational therapy . Each group underwent therapy for 30 minutes , five times a week for four weeks . Main measures : The primary variable was arm function as assessed by the Action Research Arm Test ; secondary variables were the extended Barthel Index and the box and block test score . Results : The intention-to-treat analysis revealed no statistically significant differences between the two groups at the end of treatment for any variable . Conclusions : There was no evidence of a difference between Cognitive Sensory Motor Training Therapy of Perfetti ’s method and conventional occupational therapy with respect to the restoration of h and and arm function after a stroke Background : Left-sided transcutaneous electrical nerve stimulation ( TENS ) increases right hemispheric activity , which may improve the rehabilitative outcome of hemispatial neglect . Objective : To examine the behavioral effect of electrical stimulation of the nerve afferents of the left h and during early neuropsychological rehabilitation of post-stroke patients with hemispatial neglect . Methods : This r and omized , controlled , double-blind study included 29 patients ( enrolled in the experimental or control group ) with left hemispatial neglect after right hemispheric stroke . For 3 weeks , patients received 15 therapeutic sessions involving TENS ( active or sham ) with a mesh glove applied on the entire left h and during the first 30 minutes of a 45-minute conventional visual scanning training ( VST ) .  Signs of hemispatial neglect were assessed using a psychometric test before and after treatment . Results : Univariate analysis of covariance revealed that differences between the control and experimental groups were not significant after treatment ( F(1 , 22 ) = 0.294 , P = 0.593 ) when adjusted for pre-treatment scores and time since stroke onset . This suggested that electrical stimulation failed to mitigate the severity of hemispatial neglect symptoms . Conclusion : Our study did not provide evidence of the effectiveness of  TENS when added to VST during early rehabilitation for patients with post-stroke hemispatial neglect . Other techniques ( applied alone or together ) should be sought to improve recovery in this population Sit-to-st and is a fundamental movement of human being for performing mobility and independent activity . However , Stroke people symptoms experience difficulty in conducting the sit-to-st and due to paralysis and especially ankle spasticity . Recently , transcutaneouselectrical- stimulation ( TENS ) is used to reduce pain but also to manage spasticity . The purpose of this study was to determine ( 1 ) whether TENS would lead to ankle spasticity reduction and ( 2 ) whether sit-to-st and training combined with TENS would improve spasticity , muscle strength and balance ability in stroke patients . Forty-stroke patients were recruited and were r and omly divided into two groups : TENS group ( n=20 ) and sham group ( n=20 ) . All participants underwent 30-sessions of sit-to-st and training ( for 15-min , five-times per week for 6-weeks ) . Prior to each training session , 30-min of TENS over the peroneal nerve was given in TENS group , whereas sham group received non-electrically stimulated TENS for the same amount of time . Composite-Spasticity-Score was used to assess spasticity level of ankle plantar-flexors . Isometric strength in the extensor of hip , knee and ankle were measured by h and held dynamometer . Postural-sway distance was measured using a force platform . The spasticity score in the TENS group ( 2.6±0.8 ) improved significantly greater than the sham group ( 0.7±0.8 , p<0.05 ) . The muscle strength of hip extensor in the TENS group ( 2.7±1.1 kg ) was significantly higher than the sham group ( 1.0±0.8 kg , p<0.05 ) . Significant improvement in postural-sway was observed in the TENS group compared to the sham group ( p<0.05 ) . Thus , sit-to-st and training combined with TENS may be used to improve the spasticity , balance function and muscle strength in stroke patients Background and Purpose — A sensory-based intervention called peripheral nerve stimulation can enhance outcomes of motor training for stroke survivors with mild-to-moderate hemiparesis . Further research is needed to establish whether this paired intervention can have benefit in cases of severe impairment ( almost no active movement ) . Methods — Subjects with chronic , severe poststroke hemiparesis ( n=36 ) were r and omized to receive 10 daily sessions of either active or sham stimulation ( 2 hours ) immediately preceding intensive task-oriented training ( 4 hours ) . Upper extremity movement function was assessed using Fugl – Meyer Assessment ( primary outcome measure ) , Wolf Motor Function Test , and Action Research Arm Test at baseline , immediately post intervention and at 1-month follow-up . Results — Statistically significant difference between groups favored the active stimulation group on Fugl – Meyer at postintervention ( 95 % confidence interval [ CI ] , 1.1–6.9 ; P=0.008 ) and 1-month follow-up ( 95 % CI , 0.6–8.3 ; P=0.025 ) , Wolf Motor Function Test at postintervention ( 95 % CI , −0.21 to −0.02 ; P=0.020 ) , and Action Research Arm Test at postintervention ( 95 % CI , 0.8–7.3 ; P=0.015 ) and 1-month follow-up ( 95 % CI , 0.6–8.4 ; P=0.025 ) . Only the active stimulation condition was associated with ( 1 ) statistically significant within-group benefit on all outcomes at 1-month follow-up and ( 2 ) improvement exceeding minimal detectable change , as well as minimal clinical ly significant difference , on ≥1 outcomes at ≥1 time points after intervention . Conclusions — After stroke , active peripheral nerve stimulation paired with intensive task – oriented training can effect significant improvement in severely impaired upper extremity movement function . Further confirmatory studies that consider a larger group , as well as longer follow-up , are needed . Clinical Trial Registration — URL : http://www . clinical trials.gov . Unique identifier : NCT02633215 OBJECTIVE . We investigated changes in functional arm use after retraining for stroke-related somatosensory loss and identified whether such changes are associated with somatosensory discrimination skills . METHOD . Data were pooled ( N = 80 ) from two r and omized controlled trials of somatosensory retraining . We used the Motor Activity Log to measure perceived amount of arm use in daily activities and the Action Research Arm Test to measure performance capacity . Somatosensory discrimination skills were measured using st and ardized modality-specific measures . RESULTS . Participants ’ arm use improved after somatosensory retraining ( z = −6.80 , p < .01 ) . Change in arm use was weakly associated with somatosensation ( tactile , & bgr ; = 0.31 , p < .01 ; proprioception , & bgr ; = −0.17 , p > .05 ; object recognition , & bgr ; = 0.13 , p < .05 ) . CONCLUSION . Change in daily arm use was related to a small amount of variance in somatosensory outcomes . Stroke survivors  ’ functional arm use can increase after somatosensory retraining , with change varying among survivors Background . Peripheral nerve stimulation may induce cortical adaptations as it improves pinch strength in chronic stroke patients immediately after stimulation . Objective . Test the effects of peripheral sensory stimulation on pinch strength in patients with acute and subacute stroke . Methods . Stroke patients ( N = 20 ) who had onset less than 6 months previously and could voluntarily pinch the thumb to the index finger participated in a r and omized , single-blinded , controlled study . Ten patients received 2 hours of simultaneous electrical stimulation over the median and ulnar nerves at the wrist to the level of appreciating paresthesias ( peripheral sensory stimulation group ) . Ten control patients received stimulation to the level of perception ( sham-control group ) . Pinch strength of the thumb pad to tip and to lateral side of the index finger of the paretic h and and the Action Research Arm test were tested before and immediately after the stimulation . Results . Lateral and tip pinch strength were significantly increased in both groups ( P < .05 ) . Mean ± SD of increased lateral pinch strength of peripheral sensory stimulation and sham-control groups were 1.24 ± 0.54 pounds and 0.20 ± 0.28 pounds , respectively . Mean ± SD of increased tip pinch strength of peripheral sensory stimulation and sham-control groups were 1.00 ± 0.72 pounds and 0.37 ± 0.36 pounds , respectively . Increase pinch strength of the peripheral sensory stimulation group was greater than the sham-control group , with significant difference ( P < .05 ) . The Action Research Arm test was not significantly changed after stimulation in both groups ( P > .05 ) . Conclusion . Peripheral sensory stimulation of the paretic h and may increase pinch strength of acute and subacute stroke patients immediately after stimulation This study aim ed to determine the immediate effects of somatosensory stimulation on h and function in patients with poststroke hemiparesis . Eleven patients with poststroke hemiparesis participated in this study . Four types ( no stimulation , vibration , and light and rough touches ) of somatosensory stimulation were performed r and omly for 4 days applying only one type of somatosensory stimulation each day . The box and block test ( BBT ) , the Jebsen – Taylor h and function test ( JTHFT ) , h and grip strength ( HGS ) , and movement distance and peak velocity of the wrist joint during a forward-reaching task were measured . The BBT and JTHFT scores for no stimulation [ BBT : median ( interquartile range ) , 0.00 ( −1.00 to 1.00 ) and JTHFT : 2.57 ( −0.47 to 4.92 ) ] were significantly different from those for vibration [ BBT : 3.00 ( 2.00–5.00 ) and JTHFT : −16.02 ( −23.06 to −4.31 ) ] , light touch [ BBT : 3.00 ( 1.00–4.00 ) and JTHFT : −5.00 ( −21.20 to −0.94 ) ] , and rough touch [ BBT : 2.00 ( 1.00–4.00 ) and JTHFT : −6.19 ( −18.22 to −3.70 ) ] . The JTHFT score was significantly higher for vibration than that for rough touch ( P<0.05 ) . The increase in HGS was significantly greater for light touch than that for no stimulation ( P<0.05 ) and for vibration than that for light touch ( P<0.05 ) . There were significant differences for the sagittal and coronal planes in movement distance and for the sagittal and horizontal planes in peak velocity during the forward-reaching task ( P<0.05 ) . The findings suggest that somatosensory stimulation may be advantageous to improve the h and function of patients with poststroke hemiparesis , with more favorable effects observed in vibration stimulation Objective : To investigate the feasibility and potential efficacy of ‘ activeTENS ’ ( that is transcutaneous electrical nerve stimulation ( TENS ) during everyday activities ) by assessing the immediate effects on strength , proprioception , balance/falls risk and mobility after stroke . Design : A paired- sample r and omized cross-over trial . Subjects : Twenty-nine mobile chronic stroke survivors with no pre-existing conditions limiting balance or mobility or contra-indications to TENS . Setting : University clinical research facility . Intervention : A single session of ‘ activeTENS ’ delivered via a ‘ sock electrode ’ ( 70–130 Hz , five second cycle ) plus a session of control treatment ( wearing the sock electrode with no stimulation ) , lasting approximately two hours in total . Main Outcomes : Dorsiflexor and plantarflexor strength and proprioception using an isokinetic dyanometer , balance and falls risk ( St and ing Forward Reach Test ) and gait speed ( 10-m walk test ) . Results : All participants tolerated ‘ active TENS ’  . Most parameters improved during stimulation with activeTENS ; balance ( p = 0.009 ) , gait speed ( p = 0.002 ) , plantarflexor strength ( p = 0.008 ) and proprioception of plantarflexion ( p = 0.029 ) , except dorsiflexor strength ( p = 0.194 ) and dorsiflexion proprioception ( p = 0.078 ) . Conclusions : The results provide initial evidence of the potential of ‘ active TENS ’ to benefit physical function after stroke which warrants further phase II trials to develop the intervention . Concerns that stimulation could have a detrimental impact on balance and increase risk of falls were not supported Objective : To evaluate the efficacy of intermittent pneumatic compression ( IPC ) in treating  sensory impairments in the hemiplegic upper limb in stroke patients . Design : Twenty-three stroke patients were enrolled in a r and omized , controlled preliminary trial that compared the application of intermittent pneumatic compression with a passive treatment strategy . Setting : Four Belgian 
    Output:
    