Multiple interventions for upper limb sensory impairment after stroke are described but there is insufficient evidence to support or refute their effectiveness in improving sensory impairment, upper limb function, or participants' functional status and participation. There is a need for more well-designed, better reported studies of sensory rehabilitation.
Sensory impairments significantly impact stroke survivors' roles and participation. Remediation of sensory impairments is important to survivors, but seems to be ignored in the rehabilitation process. Individual survivors' preference for involvement in decision making related to their rehabilitation planning should be ascertained. Stroke survivors feel left on their own to address their upper limb impairments long after rehabilitation services have ended. The development of services beyond the normal rehabilitation timeframes is warranted.
Sensory impairments significantly limit functional use and safety of the upper limb in people after stroke. This systematic review aimed to determine the effectiveness of interventions directed at improving sensory impairments of the upper limb after stroke.
Search Strategy
Selection CriteriaRandomized controlled trials and controlled trials comparing interventions for sensory impairment after stroke with no treatment, conventional treatment, attention placebo, or with other interventions for sensory impairment.
Data Collection and AnalysisTwo review authors selected studies, assessed quality, and extracted data. We analyzed study data using mean differences and odds ratios as appropriate. The primary outcome we considered was sensory function and secondary outcomes included upper limb function, activities of daily living, impact of stroke, and quality of life as well as adverse events.
Main ResultsWe included 13 studies, with a total 467 participants, testing a range of different interventions. Outcome measures included 36 measures of sensory impairment and 13 measures of upper limb function. All but 2 studies had unclear or high risk of bias. Although there is insufficient evidence to reach conclusions about the effects of interventions included in this review, 3 studies provided preliminary evidence for the effects of some specific interventions, including mirror therapy for improving detection of light touch, pressure, and temperature pain; a thermal stimulation intervention for improving rate of recovery of sensation; and intermittent pneumatic compression intervention for improving tactile and kinesthetic sensation. We could not perform meta-analysis due to a high degree of clinical heterogeneity in both interventions and outcomes.
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