Effects of mobilization and tactile stimulation on recovery of the hemiplegic upper limb: a series of replicated single-system studies

Arch Phys Med Rehabil. 2008 Oct;89(10):2003-10. doi: 10.1016/j.apmr.2008.03.016.


Objective: To explore the effects on motor function and impairment of mobilization and tactile stimulation for the paretic arm and hand after stroke.

Design: Replicated single-system series, ABA design.

Setting: The stroke rehabilitation ward of a community hospital in the United Kingdom.

Participants: Consecutive sample, men and women (N=6) with stroke (left or right), within 3 months of onset.

Intervention: Sixty minutes of daily mobilization and tactile stimulation to the paretic arm and hand for 6 weeks in addition to the usual rehabilitation program.

Main outcome measures: Focal disability (Action Research Arm Test [ARAT]) and motor impairment (Motricity Index arm section).

Results: All participants showed visual change in 1 or more of trend, level, or slope between baseline and intervention phases for both the ARAT and the Motricity Index. The visual analysis was confirmed through statistical testing (c statistic and/or Mann-Whitney U test) for 5 of 6 participants (statistical analysis was precluded for 1 participant). No further improvements were made on intervention withdrawal.

Conclusions: This study shows proof of concept for using mobilization and tactile stimulation to improve motor recovery after severe paresis, justifying conducting dose-finding studies as a precursor to multicenter phase III clinical trials.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Female
  • Hemiplegia / physiopathology
  • Hemiplegia / rehabilitation*
  • Humans
  • Male
  • Middle Aged
  • Physical Therapy Modalities*
  • Recovery of Function
  • Statistics, Nonparametric
  • Touch / physiology*
  • Treatment Outcome
  • Upper Extremity / physiopathology*