Stability of stereognosis after pediatric repetitive transcranial magnetic stimulation and constraint-induced movement therapy clinical trial

ABSTRACT

Objective: Poor sensibility affecting stereognosis, the ability to discriminate objects without visual input, can potentiate disuse of the paretic limb following stroke. The purpose of this study was to examine potential change in stereognosis after intervention. Methods: Stereognosis testing in a secondary subgroup of 10 children with hemiparesis and baseline stereognosis deficits (ages 11–16) after a 13-day clinical trial of real or sham repetitive transcranial magnetic stimulation (rTMS) and constraint-induced movement therapy (CIMT) is reported. All children received 10 h of CIMT while wearing a cast full-time. Results: Post-trial, 80% of participants from both intervention groups demonstrated improvement in stereognosis (95% CI: 44.4%–97.5%). Pre-trial to long-term follow-up (range: 21–57 months), 60% retained gains or improved (95% CI: 26.2%–87.8%). Between-group differences were not detected. Discussion: Children demonstrated stereognosis change following intervention. Research on this change and potential minimal clinically important differences are indicated.

KEYWORDS:

• Constraint-induced movement therapy
• hemiparesis
• non-invasive brain stimulation
• pediatrics
• stroke
• transcranial magnetic stimulation

Acknowledgments

The University of Minnesota CTSI is part of a national Clinical and Translational Science Award consortium created to accelerate laboratory discoveries into treatments for patients. We would like to thank the children and families who participated in this study.

Funding

This study is registered on the United States National Institutes of Health (NIH) clinicaltrials.gov (NCT01104064). This study was funded by NIH grant number 1 RC1HD063838-01, 1UL1RR033183-01 from the National Center for Research Resources and by grant number 8 UL1 TR000114-02 from the National Center for Advancing Translational Sciences of the National Institutes of Health to the University of Minnesota Clinical and Translational Science Institute (CTSI). The University of Minnesota Center for Magnetic Resonance Research funding supported the imaging work number P41 EB015894. This research was also supported by the Foundation for Physical Therapy Promotion of Doctoral Studies, the American Academy of Cerebral Palsy and Developmental Medicine Student and OrthoPediatrics Travel Awards University of Minnesota Leadership and Education in Neurodevelopmental Disabilities (LEND) and Minnesota’s Discovery, Research InnoVation Economy (MnDRIVE) fellowships.

Declaration of interest

The authors report no declaration of interest. The contents are solely the responsibility of the authors and do not necessarily represent the official views of the CTSI or the NIH.

Supplemental materials

Supplemental data for this article can be accessed at www.tandfonline.com/ipdr.

Additional information

Funding

This study is registered on the United States National Institutes of Health (NIH) clinicaltrials.gov (NCT01104064). This study was funded by NIH grant number 1 RC1HD063838-01, 1UL1RR033183-01 from the National Center for Research Resources and by grant number 8 UL1 TR000114-02 from the National Center for Advancing Translational Sciences of the National Institutes of Health to the University of Minnesota Clinical and Translational Science Institute (CTSI). The University of Minnesota Center for Magnetic Resonance Research funding supported the imaging work number P41 EB015894. This research was also supported by the Foundation for Physical Therapy Promotion of Doctoral Studies, the American Academy of Cerebral Palsy and Developmental Medicine Student and OrthoPediatrics Travel Awards University of Minnesota Leadership and Education in Neurodevelopmental Disabilities (LEND) and Minnesota’s Discovery, Research InnoVation Economy (MnDRIVE) fellowships.