Absence of Motor-Evoked Potentials Does Not Predict Poor Recovery in Patients With Severe-Moderate Stroke: An Exploratory Analysis.
Elizabeth S Powell, Philip M Westgate, Larry B Goldstein and 1 others
PMID 33543054WHAT IT FOUND
Stroke patients with no motor-evoked potential still improved after intensive upper-limb therapy, but less than patients who had one.
Adding nerve or brain stimulation was not clearly better than sham.
Key findings
01In 129 participants, people with and without motor-evoked potentials both improved on FMA and ARAT after therapy.
02When paired with motor training, active nerve or brain stimulation was not clearly better than sham.
03Small proportions of MEP-negative participants reached the MCID for FMA or ARAT.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
This was an exploratory analysis of data from previous studies. The included studies differed in neuromodulation type and therapy protocol. The sample was heterogeneous, with different stroke types, stroke locations, and time since stroke. Baseline scores differed among some MEP and stimulation groups. No statistical analysis was performed on the proportions reaching minimal important change thresholds.
Declared interests
The article lists equipment suppliers but does not provide a funding or conflict-of-interest declaration.
The easy way to misread this
Do not conclude that peripheral nerve stimulation or transcranial direct current stimulation has proven added benefit over sham when paired with motor training. The active stimulation group was not clearly better, and the analysis pooled heterogeneous studies.