Combined somatosensory and motor training to improve upper limb function following stroke: a systematic scoping review

Gopaul, Urvashy; Callister, Robin; Nilsson, Michael; Vliet, Paulette van

doi:10.1080/10833196.2018.1553668

Cited by 8 publications

(13 citation statements)

References 67 publications

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“…When considering integrated sensorimotor training, we have to highlight the two components of our sensorimotor therapy program; consisting of somatosensory training with consecutively the integrated sensorimotor task specific training. Only the second part of this training offered an integrated training approach (14). Reasons for our finding that contrasts our hypothesis could be attributed to trial characteristics as well as our integrated approach.…”

Section: Discussionmentioning

confidence: 59%

“…Hence, the integration of a clinical somatosensory component into motor therapy may not be of added value for motor recovery in the early rehabilitation phase. Similar, in the review of Gopaul et al improvements after sensorimotor therapy were found in a trial with stroke patients in the chronic phase but not in other studies with subacute stroke patients (14,43,44). Further research, implementing and evaluating the effect of a revised sensorimotor therapy approach, is needed to provide better insight in effective sensorimotor therapy models, the long-term effects of sensorimotor therapy and the optimal rehabilitation phase.…”

Section: Discussionmentioning

confidence: 81%

“…The effect of integrated sensorimotor therapy is underinvestigated. A recent systematic scoping review on combined somatosensory and motor training concluded that "combined somatosensory and motor training interventions have potential but cannot be recommended to improve upper limb function after stroke in clinical practice due to insufficient evidence of their efficacy" (14). de Diego et al (15) showed a positive effect of 10 sessions of sensory stimulation combined with functional activity training in chronic stroke patients on motor and somatosensory function compared to conventional therapy.…”

Section: Introductionmentioning

confidence: 99%

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Sensorimotor vs. Motor Upper Limb Therapy for Patients With Motor and Somatosensory Deficits: A Randomized Controlled Trial in the Early Rehabilitation Phase After Stroke

et al. 2020

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Background: Somatosensory function plays an important role in motor learning. More than half of the stroke patients have somatosensory impairments in the upper limb, which could hamper recovery.Question: Is sensorimotor upper limb (UL) therapy of more benefit for motor and somatosensory outcome than motor therapy?Design: Randomized assessor- blinded multicenter controlled trial with block randomization stratified for neglect, severity of motor impairment, and type of stroke.Participants: 40 first-ever stroke patients with UL sensorimotor impairments admitted to the rehabilitation center.Intervention: Both groups received 16 h of additional therapy over 4 weeks consisting of sensorimotor (N = 22) or motor (N = 18) UL therapy.Outcome measures: Action Research Arm test (ARAT) as primary outcome, and other motor and somatosensory measures were assessed at baseline, post-intervention and after 4 weeks follow-up.Results: No significant between-group differences were found for change scores in ARAT or any somatosensory measure between the three time points. For UL impairment (Fugl-Meyer assessment), a significant greater improvement was found for the motor group compared to the sensorimotor group from baseline to post-intervention [mean (SD) improvement 14.65 (2.19) vs. 5.99 (2.06); p = 0.01] and from baseline to follow-up [17.38 (2.37) vs. 6.75 (2.29); p = 0.003].Conclusion: UL motor therapy may improve motor impairment more than UL sensorimotor therapy in patients with sensorimotor impairments in the early rehabilitation phase post stroke. For these patients, integrated sensorimotor therapy may not improve somatosensory function and may be less effective for motor recovery.Clinical Trial Registration:www.ClinicalTrials.gov, identifier NCT03236376.

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Section: Discussionmentioning

confidence: 59%

Section: Discussionmentioning

confidence: 81%

Section: Introductionmentioning

confidence: 99%

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Sensorimotor vs. Motor Upper Limb Therapy for Patients With Motor and Somatosensory Deficits: A Randomized Controlled Trial in the Early Rehabilitation Phase After Stroke

et al. 2020

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“…Traditionally, rehabilitative treatments have focused on motor retraining [ 11 , 12 ], with only limited attention paid to mitigating proprioceptive deficits and negative impacts on sensorimotor performance (see [ 13 ] for a review). Not only do proprioceptive deficits interfere with motor learning, but people with proprioceptive impairments have sub-optimal functional recovery [ 5 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

Effect of Short-Term Exposure to Supplemental Vibrotactile Kinesthetic Feedback on Goal-Directed Movements after Stroke: A Proof of Concept Case Series

Ballardini

Krueger

Giannoni

et al. 2021

Sensors

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Many survivors of stroke have persistent somatosensory deficits on the contralesional side of their body. Non-invasive supplemental feedback of limb movement could enhance the accuracy and efficiency of actions involving the upper extremity, potentially improving quality of life after stroke. In this proof-of-concept study, we evaluated the feasibility and the immediate effects of providing supplemental kinesthetic feedback to stroke survivors, performing goal-directed actions with the contralesional arm. Three survivors of stroke in the chronic stage of recovery participated in experimental sessions wherein they performed reaching and stabilization tasks with the contralesional arm under different combinations of visual and vibrotactile feedback, which was induced on the ipsilesional arm. Movement kinematics were encoded by a vibrotactile feedback interface in two ways: state feedback—an optimal combination of hand position and velocity; and error feedback—the difference between the actual hand position and its instantaneous target. In each session we evaluated the feedback encoding scheme’s immediate objective utility for improving motor performance as well as its perceived usefulness. All three participants improved their stabilization performance using at least one of the feedback encoding schemes within just one experimental session. Two of the participants also improved reaching performance with one or the other of the encoding schemes. Although the observed beneficial effects were modest in each participant, these preliminary findings show that supplemental vibrotactile kinesthetic feedback can be readily interpreted and exploited to improve reaching and object stabilizing actions performed with the contralesional arm after stroke. These short-term training results motivate a longer multisession training study using personalized vibrotactile feedback as a means to improve the accuracy and efficacy of contralesional arm actions after stroke.

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“…in [ 29 ]). Second, the results of this study will be valuable to estimate the effect size and to inform a decision for larger-scale multi-centre studies in the future, since the existing evidence of similar training paradigms is still insufficient [ 9 ]. Taken together, this work will add to the knowledge of the feasibility and benefits of a combined robotic-based somatosensory and motor retraining post-stroke.…”

Section: Introductionmentioning

confidence: 99%

Robotic-based ACTive somatoSENSory (Act.Sens) retraining on upper limb functions with chronic stroke survivors: study protocol for a pilot randomised controlled trial

Sidarta

Lim

Kuah

et al. 2021

Pilot Feasibility Stud

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Background Prior studies have established that senses of the limb position in space (proprioception and kinaesthesia) are important for motor control and learning. Although nearly one-half of stroke patients have impairment in the ability to sense their movements, somatosensory retraining focusing on proprioception and kinaesthesia is often overlooked. Interventions that simultaneously target motor and somatosensory components are thought to be useful for relearning somatosensory functions while increasing mobility of the affected limb. For over a decade, robotic technology has been incorporated in stroke rehabilitation for more controlled therapy intensity, duration, and frequency. This pilot randomised controlled trial introduces a compact robotic-based upper-limb reaching task that retrains proprioception and kinaesthesia concurrently. Methods Thirty first-ever chronic stroke survivors (> 6-month post-stroke) will be randomly assigned to either a treatment or a control group. Over a 5-week period, the treatment group will receive 15 training sessions for about an hour per session. Robot-generated haptic guidance will be provided along the movement path as somatosensory cues while moving. Audio-visual feedback will appear following every successful movement as a reward. For the same duration, the control group will complete similar robotic training but without the vision occluded and robot-generated cues. Baseline, post-day 1, and post-day 30 assessments will be performed, where the last two sessions will be conducted after the last training session. Robotic-based performance indices and clinical assessments of upper limb functions after stroke will be used to acquire primary and secondary outcome measures respectively. This work will provide insights into the feasibility of such robot-assisted training clinically. Discussion The current work presents a study protocol to retrain upper-limb somatosensory and motor functions using robot-based rehabilitation for community-dwelling stroke survivors. The training promotes active use of the affected arm while at the same time enhances somatosensory input through augmented feedback. The outcomes of this study will provide preliminary data and help inform the clinicians on the feasibility and practicality of the proposed exercise. Trial registration ClinicalTrials.gov NCT04490655. Registered 29 July 2020.

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Combined somatosensory and motor training to improve upper limb function following stroke: a systematic scoping review

Cited by 8 publications

References 67 publications

Sensorimotor vs. Motor Upper Limb Therapy for Patients With Motor and Somatosensory Deficits: A Randomized Controlled Trial in the Early Rehabilitation Phase After Stroke

Sensorimotor vs. Motor Upper Limb Therapy for Patients With Motor and Somatosensory Deficits: A Randomized Controlled Trial in the Early Rehabilitation Phase After Stroke

Effect of Short-Term Exposure to Supplemental Vibrotactile Kinesthetic Feedback on Goal-Directed Movements after Stroke: A Proof of Concept Case Series

Robotic-based ACTive somatoSENSory (Act.Sens) retraining on upper limb functions with chronic stroke survivors: study protocol for a pilot randomised controlled trial

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