Sensory retraining improves light touch threshold of the paretic hand in chronic stroke survivors: a single-subject A-B design

Hejazi-Shirmard, Mahnaz; Taghizadeh, Ghorban; Azad, Akram; Lajevardi, Laleh; Rassafiani, Mehdi

doi:10.1080/08990220.2020.1736021

Cited by 6 publications

(9 citation statements)

References 41 publications

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“…There is lack of evidence that UE somatosensory training improves somatosensory impairment, motor control, function and participation after stroke. Also, the poor quality of current evidences [18,19] In similar study, findings showed that sensory retraining may be an effective adjunctive intervention for improving the light touch threshold of the hand, dexterity and upper limb motor function in chronic stroke survivors [16]. Serrada et al concluded in 2019. that the further high-quality research is required to determine the effectiveness of sensory retraining in stroke rehabilitation [19].…”

Section: Discussionmentioning

confidence: 97%

“…Findings particularly suggest the importance of somatosensory function after stroke for recovery of precision grip force control [12], safety and dexterity in the paretic hand [13] and functional independence in activities of daily living (ADL) [14,15]. Current findings showed that active and passive sensory retraining may be an effective intervention for improving the light touch threshold of the hand, dexterity, upper extremity (UE) motor function [10,16] to improve the activity of daily living in stroke patients with impaired sensory motor abilities [17]. The quality of evidence is low to moderate [18,19] so further research is required to determine the effectiveness of sensory training in stroke rehabilitation.…”

Section: Introductionmentioning

confidence: 87%

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Upper extremity sensory training after stroke

Samardzic

2021

Srp Arh Celok Lek

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Introduction. Stroke is one of the leading causes for disability worldwide. After stroke, the majority of stroke survivors experience significant arm-hand impairments and a decreased use of the paretic arm and hand in daily life. Tactile sensibility of the hand is essential for identifying objects and for motor performance. Despite important sensory contributions to normal and abnormal movement, research has predominantly focused on motor aspects of stroke recovery. In this paper, we present the effect of sensory stimulation program on arm sensation and motor recovery in subacute stroke. Case outline. In a 65 years old woman the sensibility stimulation program was administered in subacute phase of post-stroke rehabilitation, six weeks after stroke, involving active and passive somatosensory intervention, motor control, coordination, strength and balance exercises. The rehabilitation protocol was applied for four weeks, five times a week. On discharge, the results of physiotherapy assessment showed full recovery of her right arm and hand. Conclusion. This case report shows that precise assessment, problems identification and problem oriented somatosensory interventions can improve, for short period, functional motor performance of the arm involved in rehabilitation after stroke.

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Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 87%

Upper extremity sensory training after stroke

Samardzic

2021

Srp Arh Celok Lek

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“…The summation of scores will be a maximum of 66. Construct validity, inter-rater, and intra-rater reliability of this scale have been reported as very good ( 24 ).…”

Section: Methodsmentioning

confidence: 98%

“…The total scoring is by counting the number of blocks carried over the partition from one side to the other for 60 seconds. The BBT has a very high test-retest and inter-rater reliability ( 24 ).…”

Section: Methodsmentioning

confidence: 99%

Effectiveness of Self-Action Observation Therapy as a Novel Method on Paretic Upper Limb and Cortical Excitability Post-Stroke: A Single-Subject Study

Shamili

Mehraban

Azad

et al. 2021

Med. J. Islam. Republ. Iran

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Background: Action Observation Therapy (AOT) is a top-down approach that has been recently introduced in the rehabilitation of neurological disorders mainly after stroke. The main goal of this study was to investigate the effects and feasibility of a new technique in AOT procedure (called self-AOT) following periods of no treatment and routine AOT intervention on upper limb motor function, occupational performance and neurophysiological changes in a stroke patient. Methods: A single-subject A-B-A-C design was used and a 58-year-old woman with a 3-year history of left hemiplegia poststroke participated in this study. In the baseline (A1, A2) phases, the patient received no treatment. In the first intervention (B phase), she received a 4-week AOT, and in the second intervention (C phase), a 4 week of Self-AOT was practiced. In all phases, upper limb motor recovery as a target outcome was evaluated on 4 occasions using the Fugl-Meyer assessment. Upper limb function, dexterity and spasticity were assessed using Action Research Arm Test, Box-Block Test and Modified Modified Ashworth Scale respectively. Occupational Performance/Satisfaction was assessed with Canadian Occupational Performance Measure and to assess neuroplasticity, Motor Evoked Potential was recorded by Transcranial Magnetic Stimulation. Visual analysis, slope, and percentage of non-overlapping data were used for assessing the changes between phases. Results: Percentage of non-overlapping data and slopes indicated that motor recovery had clinically relevant improvements after both interventions compared to baselines. Other outcomes also showed improvements except for spasticity of wrist/elbow flexors and Motor Evoked Potential of opponens indicis. Conclusion: Self-AOT may be as effective as other procedures of AOT for improving upper limb motor function, occupational performance/satisfaction, and cortical excitability post-stroke.

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“…21 This trial occurred during the early recovery period, however, in which spontaneous neurobiological recovery co-occurs with rehabilitation-induced recovery. 21 Two small case series in chronic stroke concluded that motor rehabilitation improved tactile sensation for so me participants, 22,23 but larger controlled trials were needed.…”

Section: Introductionmentioning

confidence: 99%

Tactile Sensation Improves Following Motor Rehabilitation for Chronic Stroke: The VIGoROUS Randomized Controlled Trial

Borstad

Nichols-Larsen

Uswatte

et al. 2022

Neurorehabil Neural Repair

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Background. Up to 85% of people with chronic stroke experience somatosensory impairment, which contributes to poor sensorimotor control and non-use of the affected limb. Neurophysiological mechanisms suggest motor rehabilitation may improve tactile sense post-stroke, however, somatosensory recovery has rarely been reported in controlled trials. Objective. To compare the effect of four upper limb motor rehabilitation programs on the recovery of tactile sensation in adults with chronic stroke. Methods. Adults with chronic stroke and mild or moderate upper extremity hemiparesis ( n = 167) were enrolled in a multi-site randomized controlled trial. Participants completed three weeks of gaming therapy, gaming therapy with additional telerehabilition, Constraint-Induced Movement therapy, or traditional rehabilitation. Here, we report the results of a secondary outcome, tactile sensation, measured with monofilaments, before and after treatment, and 6 months later. Results. A mixed-effects general linear model revealed similar positive change in tactile sensitivity regardless of the type of training. On average, participants were able to detect a stimulus that was 32% and 33% less after training and at 6-month follow-up, respectively. One-third of participants experienced recategorization of their level of somatosensory impairment (e.g., regained protective sensation) following training. Poorer tactile sensation at baseline was associated with greater change. Conclusions. About one-third of individuals with mild/moderate chronic hemiparesis experience sustained improvements in tactile sensation following motor rehabilitation, regardless of the extent of tactile input in the rehabilitation program. Potential for sensory improvement is an additional motivator for those post-stroke. Characteristics of those who improve and mechanisms of improvement are important future questions. Clinicaltrials.gov NCT02631850

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Sensory retraining improves light touch threshold of the paretic hand in chronic stroke survivors: a single-subject A-B design

Cited by 6 publications

References 41 publications

Upper extremity sensory training after stroke

Upper extremity sensory training after stroke

Effectiveness of Self-Action Observation Therapy as a Novel Method on Paretic Upper Limb and Cortical Excitability Post-Stroke: A Single-Subject Study

Tactile Sensation Improves Following Motor Rehabilitation for Chronic Stroke: The VIGoROUS Randomized Controlled Trial

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