Assessment of the Impact of the Tipstim® Device Application and the Study Position on Motor Coordination and Grip Strength of the Affected Upper Limb Post-Ischemic Stroke—A Randomized Parallel Crossover Trial

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Abstract
In the acute phase of stroke, most patients have reduced efficiency of the upper limb and in the chronic phase more than half of these patients still have a deficit in the mobility of the upper limb. The aim of this study was to investigate the effect of using the tipstim® device and the tested position of the body and affected upper limb on parameters of motor coordination and grip strength in patients after an ischemic stroke. A randomized, parallel crossover study was conducted in the Rehabilitation Department. The study included 29 people aged 68 ± 9.2 years, 5–7 weeks after ischemic stroke. Patients were randomly assigned to two parallel groups (A/B = 15 people and B/A = 14 people). In each of them, the patient received both experimental (A = tipstim®) and control (B = placebo effect) treatment in a specific order. The HandTutor was used to measure the parameters of motor coordination (maximum range of motion and frequency of motion). We also used an electronic dynamometer to measure the handgrip strength. The patients were examined in two positions: sitting (unstable) and lying with the trunk and affected upper limb stabilized. Results: The analysis showed smaller differences between the measurements in the A/B group than in the B/A group, both without stabilization and with stabilization (wrist Hz = p ˂ 0.001; fingers 2–5 Hz = p ˂ 0.001; handgrip strength = p ˂ 0.049 and p ˂ 0.003). When comparing the influence of the tested position on the results of motor coordination and the handgrip strength, statistically significant differences were found in the placebo group in a stable position (Hz wrist p = 0.007, MaxROM wrist = 0.038, HzF5 = 0.039, MaxROM F4 = 0.035, HzF3 = 0.035, MaxROM F3 = 0.010, HzF2 = 0.049). Conclusions: Repeated use of the tipstim® device did not improve the tested parameters. A significant improvement in the results of coordination of movements and grip strength is possible in a stable position, lying down.

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