Thermal Stimulation in Addition to Conventional Therapy on Functional Recovery After Stroke: A Case Series

Background/Objectives: To describe changes in motor function (FMA), functional independence (BI), and quality of life (SS-QOL) associated with thermal stimulation in addition to conventional therapy in first-ever stroke. Methods: A case series with 3-month follow-up was conducted in patients during the acute and subacute phases of first-ever stroke. Treatment consisted of thermal stimulation (alternating heat > 45 °C and cold < 15 °C applied to the hemiplegic hand and foot) followed by conventional therapy for 12 weeks (5 sessions/week). Outcomes were assessed at 3 times: baseline (T0), post-treatment (T1), and 3-month follow-up (T2) using the MAS, MRC, FMA, BI, and SS-QOL. Results: In total, 51 post-stroke patients were included (33 women, 18 men; mean age, 59.3 ± 18.5 years). Muscle strength improved significantly across all four evaluated muscle groups from T0 to T1, with gains maintained at T2 (p < 0.0001), while muscle tone showed no statistically significant changes. FMA upper extremity scores increased by 34.88 points (95% CI: 31.85–37.91) and lower extremity scores by 11.00 points (95% CI: 9.56–12.44) at T1 (both p < 0.0001), with gains sustained at T2. The BI improved by 24.71 points (95% CI: 19.40–30.05; p < 0.0001) at T1, with no further significant change at T2. SS-QOL scores increased by 63.90 points (95% CI: 51.60–76.30; p < 0.0001) at T1 and continued to improve at T2 (+78.30 points; 95% CI: 65.90–90.60). All functional outcomes showed large effect sizes at T2 (η2 > 0.14). Conclusions: thermal stimulation added to conventional therapy was associated with statistically significant and sustained changes in motor function, functional independence, and quality of life after first-ever stroke, supporting its consideration as a complementary neurorehabilitation strategy.