Effects of Noxious Versus Innocuous Thermal Stimulation on Lower Extremity Motor Recovery 3 Months After Stroke  Hsin-Wen Hsu, PT, MS, Chia-Ling Lee,

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Effects of Noxious Versus Innocuous Thermal Stimulation on Lower Extremity Motor Recovery 3 Months After Stroke  Hsin-Wen Hsu, PT, MS, Chia-Ling Lee, MD, MS, Miao-Ju Hsu, PT, PhD, Hung-Chia Wu, PT, MS, Roxane Lin, PT, MS, Ching-Lin Hsieh, OT, PhD, Jau-Hong Lin, PT, PhD  Archives of Physical Medicine and Rehabilitation  Volume 94, Issue 4, Pages 633-641 (April 2013) DOI: 10.1016/j.apmr.2012.11.021 Copyright © 2013 American Congress of Rehabilitation Medicine Terms and Conditions

Fig 1 (A) Two constant temperature thermal stimulators (left: cold; right: hot). (B) The therapeutic pad and the foot plate covered the entire surface of the skin below the knee, the dorsal surface of the foot, and the sole of the foot. (C) During the development of discomfort (VAS score >7), participants were encouraged to actively move their paretic LE away from the stimuli. About one third of the participants in the experimental group required 3 to 5 times of TS-induced movements of the paretic LE during 10 repetitions of TS. The most common TS-induced movement was ankle dorsiflexion 15°, knee flexion 20°, and hip flexion 20° synchronously. Archives of Physical Medicine and Rehabilitation 2013 94, 633-641DOI: (10.1016/j.apmr.2012.11.021) Copyright © 2013 American Congress of Rehabilitation Medicine Terms and Conditions

Fig 2 Flowchart of TS intervention (a section contains 2 cycles; each cycle contains 1 heat block and 1 cold block). Archives of Physical Medicine and Rehabilitation 2013 94, 633-641DOI: (10.1016/j.apmr.2012.11.021) Copyright © 2013 American Congress of Rehabilitation Medicine Terms and Conditions

Fig 3 Flowchart showing the progress of patients participating in the study and dropouts. Archives of Physical Medicine and Rehabilitation 2013 94, 633-641DOI: (10.1016/j.apmr.2012.11.021) Copyright © 2013 American Congress of Rehabilitation Medicine Terms and Conditions

Fig 4 Temporal changes of 6 measures (mean ± SEM) in the experimental (Exp) and control groups. ∗P<.05, significant difference of change values from baseline to follow-up between groups. Archives of Physical Medicine and Rehabilitation 2013 94, 633-641DOI: (10.1016/j.apmr.2012.11.021) Copyright © 2013 American Congress of Rehabilitation Medicine Terms and Conditions