COMbined Physical and somatoSEnsory training after stroke: Development and description of a novel intervention to improve upper limb function

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

doi:10.1002/pri.1748

Cited by 8 publications

(7 citation statements)

References 68 publications

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“…Overall, participants in this study were positive about how proprioceptive intervention improves motor functions after stroke, particularly for those suffering from sensory impairment. This is consistent with recent training or exercise protocols which target proprioception and tactile senses [ 41 , 57 , 58 ]. In conjunction, the therapists also agreed strongly that an objective and reliable assessment would be useful to inform performance and track or monitor recovery progression.…”

Section: Discussionsupporting

confidence: 90%

Current clinical practice in managing somatosensory impairments and the use of technology in stroke rehabilitation

et al. 2022

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Stroke-induced somatosensory impairments seem to be clinically overlooked, despite their prevalence and influence on motor recovery post-stroke. Interest in technology has been gaining traction over the past few decades as a promising method to facilitate stroke rehabilitation. This questionnaire-based cross-sectional study aimed to identify current clinical practice and perspectives on the management of somatosensory impairments post-stroke and the use of technology in assessing outcome measures and providing intervention. Participants were 132 physiotherapists and occupational therapists currently working with stroke patients in public hospitals and rehabilitation centres in Singapore. It was found that the majority (64.4%) of the therapists spent no more than half of the time per week on somatosensory interventions. Functional or task-specific training was the primary form of intervention applied to retrain somatosensory functions in stroke survivors. Standardised assessments (43.2%) were used less frequently than non-standardised assessments (97.7%) in clinical practice, with the sensory subscale of the Fugl-Meyer Assessment being the most popular outcome measure, followed by the Nottingham Sensory Assessment. While the adoption of technology for assessment was relatively scarce, most therapists (87.1%) reported that they have integrated technology into intervention. There was a common agreement that proprioception is an essential component in stroke rehabilitation, and that robotic technology combined with conventional therapy is effective in enhancing stroke rehabilitation, particularly for retraining proprioception. Most therapists identified price, technology usability, and lack of available space as some of the biggest barriers to integrating robotic technology in stroke rehabilitation. Standardised assessments and interventions targeting somatosensory functions should be more clearly delineated in clinical guidelines. Although therapists were positive about technology-based rehabilitation, obstacles that make technology integration challenging ought to be addressed.

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Section: Discussionsupporting

confidence: 90%

Current clinical practice in managing somatosensory impairments and the use of technology in stroke rehabilitation

et al. 2022

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“…The success of this approach has been demonstrated in a randomized controlled intervention study ( Carey et al, 2011 ). In line with this special issue on the sensing brain, the potential value of combining training of sensation and movement ( Gopaul et al, 2019 ) in an integrated manner for goal-oriented action is also highlighted.…”

Section: Discussionmentioning

confidence: 85%

The Functional Tactile Object Recognition Test: A Unidimensional Measure With Excellent Internal Consistency for Haptic Sensing of Real Objects After Stroke

Mak-Yuen

Matyas

2020

Front. Neurosci.

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Introduction: Our hands, with their exquisite sensors, work in concert with our sensing brain to extract sensory attributes of objects as we engage in daily activities. One in two people with stroke experience impaired body sensation, with negative impact on hand use and return to previous valued activities. Valid, quantitative tools are critical to measure somatosensory impairment after stroke. The functional Tactile Object Recognition Test (fTORT) is a quantitative measure of tactile (haptic) object recognition designed to test one's ability to recognize everyday objects across seven sensory attributes using 14 object sets. However, to date, knowledge of the nature of object recognition errors is limited, and the internal consistency of performance across item scores and dimensionality of the measure have not been established. Objectives: To describe the original development and construction of the test, characterize the distribution and nature of performance errors after stroke, and to evaluate the internal consistency of item scores and dimensionality of the fTORT. Method: Data from existing cohorts of stroke survivors (n = 115) who were assessed on the fTORT quantitative measure of sensory performance were extracted and pooled. Item and scale analyses were conducted on the raw item data. The distribution and type of errors were characterized. Results: The 14 item sets of the fTORT form a well-behaved unidimensional scale and demonstrate excellent internal consistency (Cronbach alpha of 0.93). Deletion of any item failed to improve the Cronbach score. Most items displayed a bimodal score distribution, with function and attribute errors (score 0) or correct response (score 3) being most common. A smaller proportion of one-or two-attribute errors occurred. The total score range differentiated performance over a wide range of object recognition impairment.

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“…Similar to acupuncture (34), Tui Na on the hemiplegic UL can stimulate the peripheral nerves, and promote the activation and integration of the cortical sensorimotor network. Similar to physical therapy (35), Tui Na on the hemiplegic UL can coordinate the balance of muscle tension between muscle groups, inhibit and control spasm, and then establish a normal movement pattern. Tui Na on the spine region can promote the adjustment of the overall function of the body.…”

Section: Discussionmentioning

confidence: 99%

Study protocol of a randomized controlled trial for the synergizing effects of rTMS and Tui Na on upper limb motor function and cortical activity in ischemic stroke

Chen

Zhu²,

Mao³

et al. 2022

Front. Neurol.

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Upper limb motor dysfunction after stroke is a serious threat to the living quality of patients and their families. Recovery of upper limb motor function after stroke largely relies on the activation and remodeling of neural circuits. rTMS (repetitive transcranial magnetic stimulation) has been proved to promote the reconstruction of neural synapses and neural circuits. However, there are still a large number of patients who cannot fully recover and leave behind varying degrees of dysfunction. Considering the systemic pathology after stroke, in addition to focal brain injury, stroke can also cause extensive dysfunction of peripheral organs. The rehabilitation strategy for stroke should combine the treatment of primary brain lesions with the intervention of secondary systemic damage. The aim of this trial is to verify the efficacy of rTMS synergize with Tui Na (Chinese Massage) on upper limb motor function after ischemic stroke, and to explore the mechanism of activation and remodeling of sensorimotor neural circuits with functional near-infrared spectroscopy. Ninety patients will be randomly assigned to either rTMS + Tui Na + conventional rehabilitation group (the experimental group) or rTMS + conventional rehabilitation group (the control group) in 1:1 ratio. Intervention is conducted five sessions a week, with a total of twenty sessions. The primary outcome is Fugl-Meyer Assessment, and the secondary outcomes include Muscle Strength, Modified Ashworth Assessment, Modified Barthel Index Assessment, motor evoked potentials and functional near-infrared spectroscopy. There are four time points for the evaluation, including baseline, 2 weeks and 4 weeks after the start of treatment, and 4 weeks after the end of treatment. This study is a randomized controlled trial. This study was approved by Institutional Ethics Committee of Shanghai Third Rehabilitation Hospital Affiliated to Shanghai University of Traditional Chinese Medicine (approval No. SH3RH-2021-EC-012) on December, 16th, 2021. The protocol was registered with Chinese Clinical Trial Registry (ChiCTR2200056266), on February 3th, 2022. Patient recruitment was initiated on February 10th, 2022, and the study will be continued until December 2023.

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COMbined Physical and somatoSEnsory training after stroke: Development and description of a novel intervention to improve upper limb function

Abstract: COMPoSE is a new intervention that combines somatosensory and movement training, delivered synchronously, within the same intervention, and within the same task.

Cited by 8 publications

References 68 publications

Current clinical practice in managing somatosensory impairments and the use of technology in stroke rehabilitation

Current clinical practice in managing somatosensory impairments and the use of technology in stroke rehabilitation

The Functional Tactile Object Recognition Test: A Unidimensional Measure With Excellent Internal Consistency for Haptic Sensing of Real Objects After Stroke

Study protocol of a randomized controlled trial for the synergizing effects of rTMS and Tui Na on upper limb motor function and cortical activity in ischemic stroke

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