Intensive somatosensory stimulation to improve upper limb recovery and reduce unilateral neglect after stroke

Case description: A 64-year-old male with sub-acute right anterior circulation stroke resulting in severe upper limb (UL) dysfunction and left unilateral neglect (UN). Method/design: Single system (n=1) study (A-B-A). Intervention: Daily intensive mobilisation and tactile stimulation (MTS) involving massage, sensory stimulation, and joint and soft tissue mobilisation techniques for 6 weeks. Outcome measures: Action Research Arm Test (ARAT), Motricity Index (MI arm), and Semmes–Weinstein Monofilaments (SWM) measured function, muscle weakness and sensation daily. Data analysis: Visual analysis of plotted data. Findings: Immediate improvements in MI and SWM after just one MTS treatment session; ARAT improved after three sessions. UN behaviour also improved immediately after one MTS session. Discussion: In addition to improving UL recovery, MTS appeared to immediately reduce UN behaviour in this participant. Massage and sensory stimulation components of MTS could potentially be delivered by nurses and carers. Conclusion: The optimum way of delivering MTS and its potential to reduce unilateral neglect warrants further study