Thermal stimulation helps in stroke recovery

Alternating application of heat and cold (thermal stimulation) to the hand and wrist of stroke survivors helps to rehabilitate their paralysed upper limbs. Researchers from the National Chiao Tung University in Hsinchu, Taiwan found that cycles of heat and cold significantly enhanced the sensory and motor functions in the arms and hands of stroke patients after just a few weeks of therapy. The vast majority (85 percent) of stroke survivors experience some degree of impairment in an upper limb and recovery is often poor. Previous studies have shown that thermal stimulation can simultaneously activate many areas of the brain, process believed to help stroke patients recover function. As compared to other treatments, it represents a low-cost, simple intervention. Thermal stimulation is common in orthopaedic rehabilitation and is sometimes used to treat muscle-skeletal pain or spasticity in stroke patients. Researchers administered thermal stimulation using hot packs (heated to roughly 75 degrees C) and cold packs (chilled to less than 0 degrees C) wrapped in towels to buffer the thermal conduction. Duration of direct heating and cooling stimulation was limited to 15 to 30 seconds, repeated 10 times with 30-second pauses. Patients were encouraged to actively move their hands away from the stimulus when it became uncomfortable. The treatment was applied in 20- to 30-minute sessions five times per week for 6 weeks. Fifteen patients in the experimental group and 14 in the control group completed the treatment protocol. Thermal therapy was associated with significant improvement in sensation, wrist extension, and motor function, compared with the control group, with greatest change observed between weeks 4 and 6. The findings suggest that thermal stimulation is a good, useful and convenient technique to speed the recovery of sensory-motor function in upper limbs of stroke patients. Although an ongoing improvement after the 6-week thermal stimulation may be expected, whether the facilitation seen in the intervention period is continuous at follow-up, and what the optimal intensity is of thermal stimulation remain to be studied.