Vagus Nerve Stimulation Paired With Rehabilitation in the Home Environment for People With Chronic Post-Stroke Upper Limb Deficits: Preliminary Findings.

Background: Implantable vagus nerve stimulation paired with upper limb (UL) rehabilitation (Paired VNS) is an effective therapy for chronic ischemic stroke currently being implemented in outpatient centers. However, issues such as constraints in transportation, mobility, or caregiver availability ma...

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Published in:Advances in Rehabilitation Science & Practice Vol. 15; pp. 1 - 13
Main Authors: Patel, Ruchi, Spinelli-Guglielmo, Lisa, Antares, Kathleen A., Diedrich, Annie, Zera, Sarah M.
Format: pictorial research tables/charts Journal Article
Published: Sage Publications Inc. 5/13/2026
Online Access:View this record in EBSCOhost
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      dt: 5/13/2026
      vid: 15
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      pub: Sage Publications Inc.
      place: Thousand Oaks, California
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        atl: Vagus Nerve Stimulation Paired With Rehabilitation in the Home Environment for People With Chronic Post-Stroke Upper Limb Deficits: Preliminary Findings.
      aug:
        au:
          Patel, Ruchi
          Spinelli-Guglielmo, Lisa
          Antares, Kathleen A.
          Diedrich, Annie
          Zera, Sarah M.
        affil: NeuroAbilityOT, PLLC, Mooresville, NC, USA
      sug:
        subj:
          Stroke Rehabilitation
          Stroke Complications
          Chronic Disease
          Vagal Stimulation
          Home Environment
          Home Health Care
          Upper Extremity
          Patient Attitudes Evaluation
          Patient Safety Evaluation
          Patient Compliance Evaluation
          Professional Compliance
          Human
          Male
          Female
          Adult
          Middle Age
          Aged
          Stroke Patients
          Funding Source
          United States
          Occupational Therapists
          Physical Therapists
          Scales
          Data Analysis Software
          Outcome Assessment
          Patient-Reported Outcomes
          Activities of Daily Living
          Descriptive Statistics
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
          Female
      ab: Background: Implantable vagus nerve stimulation paired with upper limb (UL) rehabilitation (Paired VNS) is an effective therapy for chronic ischemic stroke currently being implemented in outpatient centers. However, issues such as constraints in transportation, mobility, or caregiver availability may decrease access to in-clinic therapy for some individuals. An alternative approach may be a mobile therapy model in which outpatient rehabilitation services are delivered in the individual's home. The VNS-REHAB At-Home study is a single-arm trial aimed at assessing feasibility of therapist-activated Paired VNS in the home (or mobile Paired VNS) by examining protocol compliance, therapist/patient acceptance, and safety. The goal of this report was to present the preliminary findings from the first participant cohorts. Methods: Participants completed up to 36 hours of therapist-activated mobile Paired VNS within 18 weeks. Therapist-led sessions were supplemented with self-activated VNS during UL functional tasks. The primary feasibility endpoint was the proportion of participants who completed at least 24 hours of mobile Paired VNS. Outcomes included total session hours, therapist/participant acceptance, and safety. While this study was not designed to establish definitive treatment effects, UL impairment/activity, and patient-reported measures were assessed at multiple timepoints as secondary exploratory outcomes. Results: Participants (n = 11) completed a median of 37.8 (32.5-42.4) hours of mobile Paired VNS over 13 (8-18) weeks. All participants met the primary endpoint. Overall, participants and therapists were satisfied (n = 8) or very satisfied (n = 14). Fugl-Meyer Assessment-Upper Extremity scores improved by a median of 7 points. All participants reported improvements in measures of UL use, activities of daily living, and/or participation. Adverse events were reported amongst 3 participants, and there were no serious events related to procedure or device use. Conclusions: Preliminary data from the VNS-REHAB At-Home trial demonstrate that mobile Paired VNS was successfully implemented, well-accepted, and safe in the home setting, with observed meaningful UL improvements. These initial findings support the ongoing evaluation of mobile Paired VNS as an accessible alternative to clinic-based delivery. Trial Registration: NCT05691023; https://clinicaltrials.gov/study/NCT05691023
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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