Automated and Quantitative Assessment of Tactile Mislocalization After Stroke

Abstract

Topesthesia, the recognition of tactile stimulation location on the skin, can be severely affected by neurological injuries, such as stroke. Despite topesthesia being crucial for manipulating objects and interacting with the environment during activities of daily living, deficits cannot be quantitatively captured with current clinical assessments and are, as a consequence, not well-understood. The present work describes a novel automated assessment tool for tactile mislocalization in neurological patients with somatosensory deficits. We present two cases of ischemic stroke patients, describe their tactile localization deficits with the automated assessment, and compare the results to a standard manual clinical assessment. Using the automated assessment tool, it was possible to identify, locate, precisely quantify, and depict the patients' deficits in topesthesia. In comparison, the clinical assessment was not sensitive enough and some deficits would remain undetected due to ceiling effects. In addition, an MRI structural analysis of the lesion supported the existence of somatosensory deficits. This novel and quantitative assessment may not only help to raise awareness of the implications of deficits in topesthesia, but would also allow monitoring recovery throughout the rehabilitation process, informing treatment design, and objectively evaluating treatment efficacy.

Integrating Tactile Feedback Technologies Into Home-Based Telerehabilitation: Opportunities and Challenges in Light of COVID-19 Pandemic

“…The assessment of somatosensory functions, including proprioception and sensitivity to light touch, pressure, and temperature, cannot be done remotely in the traditional way where the therapist applies the stimulation and evaluates the performance using scales. Portable, and often wearable devices that apply multimodal stimulations have the potential to provide reliable and quantitative information regarding somatosensory impairments in a home-based setting (Rinderknecht et al, 2015 , 2019 ). Such portable devices have already been used in some virtual reality systems for baseline measurements of activity and kinematics and for tracking changes over time (Patel et al, 2012 ; Chen et al, 2015 ; Bortone et al, 2018 ).…”

“…The assessment provides a standardized, repeatable measurement as well as continuous outcome measures on ratio scales (Rinderknecht et al, 2015 ). It was tested on healthy individuals (Rinderknecht et al, 2015 ) and on stroke survivors (Rinderknecht et al, 2019 ).…”

Peer Review #1 of "Modernising tactile acuity assessment; clinimetrics of semi-automated tests and effects of age, sex and anthropometry on performance (v0.1)"

“…Measures of tactile acuity have been utilised to identify somatosensory impairments in a variety of painful conditions, such as musculoskeletal disorders [1][2][3], chronic pain [4,5], amputation [6,7], neuropathy [8], stroke [9], arthritis [10], complex regional pain syndrome [11] and spinal cord injury [12]. Patients with persistent pain typically demonstrate poorer tactile acuity than healthy controls [4], which is thought to reflect changes in somatosensory processing related to the condition.…”

“…A variety of tests have recently been developed to improve tactile acuity assessment, such as the two-point orientation test [28], point-to-point test [35], tactile acuity charts [36], grating orientation task [37], and two-point estimation task [38,39]. Additionally, technological developments instigated semi-automated tests which may be less affected by inter-rater variability [7,9,40]. An added benefit of these semi-automated tools is the potential for independent sensory training.…”

A notação logarítmica como opção de registro objetivo da estesiometria: um estudo piloto

“…Testes físicos são importantes instrumentos para avaliação e acompanhamento de pacientes em reabilitação e servem para o registro psicométrico do estado físico funcional prejudicados por diferentes acometimentos sensoriomotores 1 , em particular, prejuízos perceptivos da sensibilidade tátil são recorrentes sequelas neurológicas, como as causadas por um Acidente Vascular Encefálico (AVE) 2 . Na contramão desse entendimento, é notório na literatura como as sequelas motoras recebem maior importância no AVE, em detrimento aos estudos focados no peso que os danos somatossensoriais têm sobre a recuperação funcional geral e à independência nas Atividades da Vida Diária dos pacientes 3 .…”