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

Abstract

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.

Critical quality appraisal and algorithm development of clinical practice guidelines for management of poststroke sensory loss: a systematic review

“…Additionally, among somatosensory impairments, poststroke sensory loss is the most common. Over 50% of patients who had a stroke might experience somatosensation loss in several modalities such as touch, pain, temperature, vibration and entity 2 3. The reported prevalence of poststroke visual impairment varies from 19% to 92%.…”

“…Mild patients only have slight discomfort and can have a normal life. Severe cases might lead to joint and muscle contracture, increased risk of skin damage and central pain, which seriously affect the quality of life 3 6. Despite all these adverse impacts, poststroke sensory loss has received less attention than motor dysfunction, which is relatively easier to screen and assess 7…”

Physiotherapy Efficiency in Post-stroke Upper Extremity Spasticity: TENSvs. Ultrasoundvs. Paraffin

“…For patients, post-stroke rehabilitation encompasses physical therapy, electrotherapy, massage, hydrotherapy, thermotherapy, occupational therapy, immersive or augmented virtual reality therapy, robotic training, speech therapy, and psychotherapy. The main goal of rehabilitation post stroke is to restore motor capacity for ambulation, activities of daily living (ADLs), and social and professional reintegration (23)(24)(25)(26).…”