Abstract / Summary
Abstract Background Relieving flexor spasticity, enhancing extensor strength, and improving hand function in patients with stroke remain significant clinical challenges. Mechanical Digitorum Sensory Stimulation (MDSS), a novel therapy that applies precise mechanical pressure to the affected fingers, may address these issues; however, its effects and mechanisms have not been thoroughly studied. Methods Sixty convalescent patients with post-stroke hemiplegia were randomly assigned to a Control group (conventional rehabilitation + sham MDSS) or an MDSS group (conventional rehabilitation + MDSS) for 3–4 weeks. Muscle spasticity, strength, upper-limb motor function, and activities of daily living were assessed using the Modified Ashworth Scale (MAS), Manual Muscle Testing (MMT), Fugl-Meyer Assessment–Upper Extremity (FMA-UE), and Modified Barthel Index (MBI), respectively. Functional near-infrared spectroscopy (fNIRS) was used to measure oxyhemoglobin (HbO) concentrations in regions of interest (ROIs) during the resting state (RS) and task state (TS; i.e., MDSS) to evaluate cortical excitability and functional connectivity (FC) by calculating correlations of HbO concentration changes between specific ROIs. Results After the intervention, the MDSS group showed significantly lower MAS scores for all finger flexors ( P < 0.001) and significantly higher MMT scores for all finger extensors, as well as higher FMA-UE and MBI scores ( P < 0.01) compared with the Control group. Regarding cortical excitability, increases in HbO concentration were higher in most ROIs in the MDSS group than in the Control group, including 10 ROIs (83.33%) during RS and 11 ROIs (91.67%) during TS. Moreover, increases in FC across all ROI-to-ROI pairs were greater in the MDSS group than in the Control group during both RS and TS. Conclusions MDSS effectively alleviates flexor spasticity, enhances extensor strength, and improves upper-limb motor function in patients with stroke. These effects are associated with enhanced cortical excitability and strengthened functional connectivity, supporting MDSS as a promising rehabilitation strategy for hemiparetic hand recovery. Trial registration The study protocol was registered in the Chinese Clinical Trial Registry (Website https//www.chictr.org.cn/showproj.html?proj=176575 Registration Number ChiCTR2200063792)