Sensory loss in stroke patients: Effective training of tactile and proprioceptive discrimination

Carey, Leeanne; Matyas, Thomas A.; Oke, Linda E.

doi:10.1016/0003-9993(93)90158-7

Cited by 227 publications

(261 citation statements)

References 26 publications

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“…However, most of the taskspecifi c training evidence relates to post-stroke recovery. It has been found to be effective in cognitive neurorehabilitation (Calvanio et al, 1993), sensory retraining (Carey et al, 1993), gait retraining (Hesse, 1999;Peurala et al, 2004;Sullivan et al, 2007), sit-to-stand retraining (Canning et al, 2003) and motor training of the upper limb (Feys et al, 1998;Byl et al, 2003;Blennerhassett and Dite, 2004;Page et al, 2004Page et al, , 2005Hakkennes and Keating, 2005;WoodDauphinee and Kwakkel, 2005;Michaelsen et al, 2006;Wolf et al, 2006). Task-specifi c training is a core element of a number of interventions, as discussed below.…”

Section: Evidence For Task-specifi C Training In Rehabilitationmentioning

confidence: 99%

Task‐specific training: evidence for and translation to clinical practice

Hubbard

Neilson²

2009

Occupation Therapy Intl

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367

279

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Section: Evidence For Task-specifi C Training In Rehabilitationmentioning

confidence: 99%

Task‐specific training: evidence for and translation to clinical practice

Hubbard

Neilson²

2009

Occupation Therapy Intl

Self Cite

367

279

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“…22 Difficulties in tactile and proprioceptive discrimination can limit a person's spontaneous hand use and the ability to manipulate and grip objects, affecting quality of life and, perhaps more importantly, safety. [23][24][25] Given the impact of somatosensation on function and its wide variation across individuals and across the lifespan, the NIH Toolbox aimed to include this domain as part of the battery to evaluate sensory function for use in epidemiologic and prospective studies. …”

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confidence: 99%

Somatosensation assessment using the NIH Toolbox

et al. 2013

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Touch sensation is one element of sensory function. As such, somatosensation is one of the sensory domains included in the NIH Toolbox, which is an assessment battery for measuring a range of human functions including emotional health, sensation, cognition, and motor function. We evaluated a variety of methods for inclusion in the NIH Toolbox main battery. In a convenience sample of 409 participants, we evaluated aspects of kinesthesia, pain, and tactile discrimination. We present results on these measures across the lifespan and discuss implications for future studies that use the NIH Toolbox and these measures. Touch sensations contribute to somatic aspects of body scheme as a basis for interacting with the environment. 1 Somatosensation includes responses to touch, pressure, temperature, and changes in movement related to the skin and joints. 2,3 After a series of meetings, a team of consultants to the NIH Toolbox with expertise in somatosensation defined the construct to include the following.Somatosensory function refers to the detection, discrimination, and recognition of body sensations. Somatosensation includes submodalities of touch sensation such as light touch, vibration, firm pressure and texture discrimination, proprioception involving sensing the location and movement of body parts, temperature sensation, and pain. For the NIH Toolbox, the term "somatosensation" will refer to all aspects of touch and proprioception that contribute to a person's awareness of his or her body parts and the direct interface of these with objects and the environment. The experience of sensing often involves a more complex integration of somatosensory inputs and may be influenced by emotional and social contexts.Somatosensation is mediated, in part, by the somatosensory and posterior parietal cortices, which underlie the ability to identify tactile characteristics of surroundings, create meaning about sensations, and formulate body actions related to the sensations. [4][5][6] Proprioception-based abilities include locating one's limbs without looking, directing a limb to a given point, and judging the weight of an object. 7 The term kinesthesia specifically refers to the ability to detect the movement and position of one's limb in space without vision. 1 Somatosensory function changes over the lifespan and strongly affects functioning in everyday life. 1,8,9 People in mid to late adulthood experience decreased sensitivity to light touch and texture discrimination compared with children, adolescents, and young adults. [10][11][12][13] There are also age-related differences in cutaneous pain, 14 vibration and warm temperature sense, 15-17 and spatial acuity. 18-20 Much of this decline over time is attributed to progressive change in the sensitivity of cutaneous receptors 21 and has functional implications. 22 Difficulties in tactile and proprioceptive discrimination can limit a person's spontaneous hand use and the ability to manipulate and grip objects, affecting quality of life and, perhaps more importantly, saf...

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“…Historically, Vinograd, Taylor and Grossman (1962) proposed retraining of the post stroke hand that involved placing objects of different weight, shapes and texture in the hand and retraining the stroke survivor with and without the use of vision. Carey, Matyas, and Oke (1993) and Carey (1995) proposed a method of sensory re-education that focused on tactile discrimination and proprioception due to their common impairment after stroke. The sensory re-education approach included principles of repeated presentation of targeted discrimination tasks, graded stimuli, active exploration of the stimuli with vision occluded, and use of anticipation and feedback.…”

Section: Non-specific Repeated Sensory Exposurementioning

confidence: 99%

“…They have been defined as "systematically developed statements to assist health professionals and patient decisions about appropriate health care for specific circumstances" (Field & Lohr, 1992, pp 2). The recommendations of the clinical practice guidelines available at the time of the commencement of data collection for this thesis (2008 -2009) Sensory specific training (Carey, Matyas, & Oke, 1993;Yekutiel & Guttman, 1993;Byl et al, 2003) sensory-related training (Carey & Matyas, 2000), and cutaneous Literature reviews are another source of information therapists may draw on for CDM. Therefore a brief summary of literature reviews examining interventions for ULPSSI is presented here.…”

Section: Ulpssimentioning

confidence: 99%

“…The loss of detection of touch sensation has been noted in up to 65% to 94% of all stroke survivors (Acerra, 2007;Carey et al, 1993). Impairment in proprioception (ability to sense the position and orientation of parts of the body) (17% to 52%), vibration (44%), light touch (32% to 89%), and loss of pinprick sensation (35% to 71%) have also been noted (Acerra, 2007;Hunter & Crome, 2002;Tyson et al, 2008).…”

Section: Introductionmentioning

confidence: 99%

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Understanding and supporting occupational therapists clinical decision-making for the management of upper limb post stoke sensory impairment

Doyle¹

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BackgroundStroke survivors form the largest client group seen by occupational therapists and a large proportion of these stroke survivors experience upper limb post-stroke sensory impairments (ULPSSI) which impact upper limb function and participation. This thesis addresses the clinical decision-making (CDM) of occupational therapists when managing ULPSSI. No appraised and synthesised summary of the research evidence related to the effectiveness of interventions for ULPSSI is available to support therapists' CDM.Information on occupational therapists' practice choices and decisions about managing ULPSSI and the survivors' perspective on ULPSSI is scant. This information could support occupational therapists CDM when addressing ULPSSI and potentially improve stroke survivors' outcomes. Thesis AimsThis thesis aims to:1. Synthesise the effectiveness of interventions for ULPSSI; 2. Explore how occupational therapists make and manage decisions regarding ULPSSI management; 3. Describe practice choices occupational therapists commonly make when managing ULPSSI and the sources of information they use to make these decisions; 4. Compare current assessment choices and intervention practices with recommendations from the research evidence and clinical practice guidelines; 5. Describe the stroke survivors' perspective with regard to ULPSSI; and 6. Design and pilot an evidence-based, theory-driven educational intervention to support occupational therapists' CDM when addressing ULPSSI. Thesis MethodsFive distinct studies addressed the above aims. A Cochrane systematic review evaluated the evidence for the effectiveness of ULPSSI interventions.iii  Twelve occupational therapists participated in a qualitative descriptive study exploring therapists' practice choices and CDM related to ULPSSI. Based on the qualitative study, a survey of 187 occupational therapists described therapists' current practice choices regarding ULPSSI management and factors impacting CDM. A qualitative descriptive study using semi-structured interviews with 15 stroke survivors explored their experience of ULPSSI and the associated rehabilitation encounter. Finally, based on the need for training expressed by the survey participants, a one group pre-and post-test design, feasibility study evaluated the effect of a one day, theory-based educational intervention on 19 occupational therapists' knowledge, perceived behavioural control, attitudes and intended behaviour regarding ULPSSI management, research utilisation, and shared decision-making. Workshop content incorporated information from the prior research studies forming this thesis. ResultsA Cochrane systematic review located 13 randomised controlled trials (RCTs) addressing ULPSSI interventions, with benefit shown from individual RCTs evaluating mirror therapy, a graded thermal stimulation, and intermittent pneumatic compression. Other single RCTs reporting statistically significant results for repetitive peripheral magnetic stimulation, early intensive task-orientated training and graded...

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Sensory loss in stroke patients: Effective training of tactile and proprioceptive discrimination

Cited by 227 publications

References 26 publications

Task‐specific training: evidence for and translation to clinical practice

Task‐specific training: evidence for and translation to clinical practice

Somatosensation assessment using the NIH Toolbox

Understanding and supporting occupational therapists clinical decision-making for the management of upper limb post stoke sensory impairment

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