The effects of tactile stimulation and transcutaneous electrical nerve stimulation on upper limb function and daily activities in patients with stroke: a randomized controlled trial

The purpose of this study was to evaluate the separate effects of tactile stimulation (TS) and transcutaneous electrical nerve stimulation (TENS), combined with occupational therapy (OT) and physiotherapy (PT), on sensory-motor recovery in the upper limb of patients with stroke. Thirty-six patients were randomly assigned to three groups (mean age: TS group = 60.7, TENS group = 54.1, control group = 52.2 years). The average onset time was 9.7 months for the TS group, 11.1 months for the TENS group, and 10.2 months for the control group. Participants underwent a 2-week intervention provided in addition to standard OT and PT. The TS group received coarse sand stimulation (rubbing) over the affected hand and forearm for 15 min per session. The TENS group underwent electrical stimulation applied to the affected forearm for 30 min per session (10 Hz), while the control group received sham stimulation with 1 min of active current. Hand function was assessed with the Semmes-Weinstein monofilaments and grip strength, dexterity with the box and block test and Southampton hand assessment procedure, and performance in daily activities with the assessment of motor and process skills. In the TS group, patients significantly improved hand sensory perception, grip strength, and dexterity while the TENS group showed improvement in grip strength and dexterity. The control group exhibited no significant changes. Between-group comparisons revealed significant differences favoring TS for hand sensory perception and TENS for dexterity. These findings suggest that adding TS or TENS to OT and PT may enhance sensory-motor recovery after a stroke.