Evaluation of Intervention Effectiveness of Sensory Compensatory Training with Tactile Discrimination Feedback on Sensorimotor Dysfunction of the Hand after Stroke

Kitai, Ken; Odagiri, Masashi; Yamauchi, Ryosuke; Kodama, Takayuki

doi:10.3390/brainsci11101314

Cited by 6 publications

(5 citation statements)

References 51 publications

(82 reference statements)

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“…The hands have fine motor skills, and the sensory cortex occupies a large proportion of the functional areas of the brain ( Williams and Warwick, 1973 ). Hand sensory impairment is one of the common manifestations of hemiplegia, which affects the flexibility of hand movements ( Kitai et al, 2021 ). We found that the impairment of 2-PD was worse than that of light touch sensation in patients with stroke, which is consistent with Lima et al (2015) and Wolny et al (2017) .…”

Section: Discussionmentioning

confidence: 99%

Which sites better represent the sensory function of hands in convalescent stroke patients? A study based on electrophysiological examination

Liu

et al. 2023

Front. Neurosci.

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BackgroundAssessing hand sensation in stroke patients is necessary; however, current clinical assessments are time-consuming and inaccurate.ObjectiveThis study aimed to explore the nature of light touch sensation and two-point discrimination (2-PD) of different hand sites in convalescent stroke patients based on somatosensory evoked potentials (SEP).MethodsLight touch sensation and 2-PD of the thumb, the index finger, the little finger, thenar, and hypothenar were measured (n = 112) using sensory measurement tools. Sensory differences among the hand sites were then compared. The correlation analysis between SEP and the hemiplegic hand function was made. Sensory functions were divided into three levels: sensory intactness, sensory impairment, and sensory loss.ResultsLight touch sensations were mainly associated with sensory impairment in the finger and palm region. The 2-PD of the finger region was mainly sensory loss and that of the palm region was mainly sensory impairment. There was no statistical difference in the light touch sensation among the sites of the hand. The correlation coefficients between the 2-PD and SEP N20 amplitudes differed. The correlation coefficients of the thenar and hypothenar were the smallest, and that of the finger was the largest. Light touch sensation and 2-PD in patients with stroke were related to the hemiplegic hand function.ConclusionAny site on the hand could be selected as the measurement site for light touch sensation. The little finger and hypothenar may be appropriate sites when screening for 2-PD. To improve the patient’s recovery they could receive more sensory stimulation of the hand.

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Section: Discussionmentioning

confidence: 99%

Which sites better represent the sensory function of hands in convalescent stroke patients? A study based on electrophysiological examination

Liu

et al. 2023

Front. Neurosci.

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“…We intervened with this device to provide real-time somatosensory feedback to the patient by restoring contact information in the paralyzed finger with a vibrator and transmitting this information from the clavicle. Kitai et al [37] reported that the FMA-UE of the paralyzed upper extremity improved from 25/66 to 36/66 points and that the sense of motion was improved when the same device was used on a stroke patient. Meanwhile, no changes in passive and active sensory function were observed in the present case.…”

Section: Discussionmentioning

confidence: 99%

“…Meanwhile, no changes in passive and active sensory function were observed in the present case. Previous studies have also included electroencephalographic measurements, showing that the device can be used to activate bilateral visual association areas, primary somatosensory areas, superior parietal lobes, and inferior parietal lobes (angular gyrus and supramarginal gyrus) [37]. Of these, the activation of the inferior parietal lobule is significant, since it is responsible for multisensory integration and the generation of a sense of agency.…”

Section: Discussionmentioning

confidence: 99%

Effects of Vibration-Based Generation of Timing of Tactile Perception on Upper Limb Function After Stroke: A Case Study

Awaji,

Fuchigami,

Ogata

et al. 2023

Cureus

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Sensorimotor dysfunction of the fingers and hands hinders the recovery of motor function post-stroke. Generally, hemiplegic patients are unable to properly control the dynamic friction generated between their fingers and objects during hand/finger muscle activity. In addition to sensory information, a sense of agency generated by the temporal synchronization of sensory prediction and sensory feedback is required to control this dynamic friction. In the present study, we utilized a novel rehabilitation device that transmits real-time fingertip contact information to a transducer in a case of stroke hemiplegia with sensorimotor deficits and stagnated hand/finger motor performance. Post-intervention, the patient's upper extremity motor function score (FMA-UE), which had previously been in a state of arrested recovery, improved from 51/66 to 61/66, especially in the wrist joints. Excessive grip force during object grasping and frequency of falling objects was notably decreased post-intervention. We believe that rehabilitation tasks using perceptual generation via transducer will be a new tool for the rehabilitation of post-stroke hand/finger sensorimotor deficits.

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“…Based on these theories, to reconstruct body awareness associated with hand movements, in addition to synchronous matching of visual information at the expense of sensory information, a compensatory function that detects the dynamic friction that occurs when the hand touches an object in real-time is needed. Therefore, Kitai et al [82] devised and verified an approach for sensory compensation by vibrational stimuli for vibration information (deep sensations). The deep senses are excellent at detecting pressure changes and mechanical forces associated with joint movement and transmitting them to the brain.…”

Section: Proposed New Rehabilitation Technique For Psimentioning

confidence: 99%

Clinical Usefulness of Real-time Sensory Compensation Feedback Training on Sensorimotor Dysfunction after Stroke

Kodama¹,

Kitai²

2023

Stroke - Management Pearls

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The sensory dysfunction after the stroke also greatly affects motor function. In particular, it is known that the presence of sensory dysfunction in the fingers causes loss of somatosensory muscle reflex control and excessive muscle output when grasping objects. These are called sensorimotor dysfunction and have been shown to have a significant impact on prognosis. One element to improve this dysfunction is to reconstruct the “Sense of Agency (SOA) subject feeling” and it has become clear that SOA is enhanced by matching the collation information related to motor intention and sensory feedback in time. In order to reconstruct the SOA associated with the movement of the fingers of patients with sensorimotor dysfunction, it is important to match motor intentions while using visual information as compensation for tactile sensory information. Furthermore, considering the functional characteristics of the fingers, it is also important to adjust the fine muscle output from feedback information synchronously discriminating and recognizing somatosensory information generated by resistance, friction, etc., when an object is actively touched. This chapter outlines the importance of rehabilitation of sensory feedback for poststroke sensorimotor dysfunction and investigates the usefulness of intervention with a real-time sensory compensation feedback system that can input tactile sensory information via vibratory stimulation (deep sensation) to other body parts where sensory function is preserved.

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Evaluation of Intervention Effectiveness of Sensory Compensatory Training with Tactile Discrimination Feedback on Sensorimotor Dysfunction of the Hand after Stroke

Cited by 6 publications

References 51 publications

Which sites better represent the sensory function of hands in convalescent stroke patients? A study based on electrophysiological examination

Which sites better represent the sensory function of hands in convalescent stroke patients? A study based on electrophysiological examination

Effects of Vibration-Based Generation of Timing of Tactile Perception on Upper Limb Function After Stroke: A Case Study

Clinical Usefulness of Real-time Sensory Compensation Feedback Training on Sensorimotor Dysfunction after Stroke

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