Tactile stimulation programs in patients with hand dysesthesia after a peripheral nerve injury: A systematic review

Abstract

Study design: This is a systematic review performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards.

Introduction: Diverse approaches based on tactile stimulation are used in hand rehabilitation settings to treat touch-evoked dysesthesias. However, there is a lack of literature synthesis on the description and the effectiveness of the various approaches based on tactile stimulation that can be used for treating hand dysesthesia after nerve injury.

Purpose of the study: The purpose of the study was to summarize the current evidence on tactile stimulation programs for managing touch-evoked hand dysesthesia due to nerve injury.

Methods: The search was carried out on Medline, Embase, CINAHL, and the Cochrane Library databases. The selected studies had to present patients with touch-evoked dysesthesia after nerve injury who were treated with tactile stimulation approaches to reduce pain. The methodological quality of the included studies was assessed using the methodological index for nonrandomized studies scale, as well as the risk of bias.

Results: Eleven studies met the inclusion criteria. These studies present tactile stimulation interventions that are heterogeneous relative to the target populations and the intervention itself (desensitization versus somatosensory rehabilitation method). Painful symptoms appear to diminish in patients with touch-evoked hand dysesthesia, regardless of the tactile stimulation program used. However, the included studies present significant risks of bias that limit the confidence in these results.

Discussion: The evidence does not unequivocally support the beneficial effects of tactile stimulation to treat touch-evoked hand dysesthesia.

Conclusion: Future studies with more rigorous methodological designs, such as randomized controlled trials, are required to verify the potential benefits of these approaches.

Keywords: Allodynia; Desensitization; Dysesthesia; Hand exercises; Pain; Somatosensory rehabilitation.