Somatosensory Impairments in the Upper Limb Poststroke

Meyer, Sarah; Bruyn, Nele De; Lafosse, Christophe; Dijk, Margaretha van; Michielsen, Marc; Thijs, Liselot; Truyens, Veronik; Oostra, Kristine; Krumlinde‐Sundholm, Lena; Peeters, André; Thijs, Vincent; Feys, Hilde; Verheyden, Geert

doi:10.1177/1545968315624779

Cited by 67 publications

(39 citation statements)

References 53 publications

(97 reference statements)

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“…No differences in motor impairment of the arm and leg were found between patients with left, right, and no USN, which is in contrast with prior studies (Meyer et al, 2016;Nijboer, Kollen, et al, 2014). In, for example, the study by , a hampering effect of USN on motor functioning and motor recovery was described.…”

Section: Physical Functioning and Physical Independencecontrasting

confidence: 80%

Differences between left- and right-sided neglect revisited: A large cohort study across multiple domains

Brink

Verwer

Biesbroek

et al. 2016

Journal of Clinical and Experimental Neuropsychology

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Left USN (15.82%) was more frequent than right USN (9.25%). Demographic and stroke characteristics were comparable between groups. The lateralized attentional deficit was most severe in left USN. USN in both peripersonal and extrapersonal space was more frequently left-sided in nature. Search efficiency was lower in left USN. Balance was poorer in right USN. No differences between left and right USN were found for cognitive ability, communication, motor strength, mobility, and self-care. Most patients with left USN had right-hemispheric lesions, whereas patients with right USN could have lesions in either the left or the right hemisphere. To conclude, left and right USN are both common after stroke. Although the lateralized attention deficit is worse in left than in right USN, consequences at the level of physical functioning and physical independence are largely comparable. From a clinical perspective, it is important to systematically screen for USN, both after right- and after left-hemisphere damage.

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Section: Physical Functioning and Physical Independencecontrasting

confidence: 80%

Differences between left- and right-sided neglect revisited: A large cohort study across multiple domains

Brink

Verwer

Biesbroek

et al. 2016

Journal of Clinical and Experimental Neuropsychology

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“…Patients with previous stroke or intracerebral hemorrhage were also relatively under‐represented in this study. Other possible predictors of upper limb outcome also need to be explored, such as impaired upper limb somatosensation, vision, visuospatial attention, and cognition 3, 34, 35. It is possible that PREP2 predictions, which are based on motor system measures, are less likely to be achieved when the patient's motor performance is also affected by deficits in sensory and cognitive domains.…”

Section: Discussionmentioning

confidence: 99%

PREP2: A biomarker‐based algorithm for predicting upper limb function after stroke

Stinear

Byblow

Ackerley

et al. 2017

Ann Clin Transl Neurol

241

313

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ObjectiveRecovery of motor function is important for regaining independence after stroke, but difficult to predict for individual patients. Our aim was to develop an efficient, accurate, and accessible algorithm for use in clinical settings. Clinical, neurophysiological, and neuroimaging biomarkers of corticospinal integrity obtained within days of stroke were combined to predict likely upper limb motor outcomes 3 months after stroke.MethodsData from 207 patients recruited within 3 days of stroke [103 females (50%), median age 72 (range 18–98) years] were included in a Classification and Regression Tree analysis to predict upper limb function 3 months poststroke.ResultsThe analysis produced an algorithm that sequentially combined a measure of upper limb impairment; age; the presence or absence of upper limb motor evoked potentials elicited with transcranial magnetic stimulation; and stroke lesion load obtained from MRI or stroke severity assessed with the NIHSS score. The algorithm makes correct predictions for 75% of patients. A key biomarker obtained with transcranial magnetic stimulation is required for one third of patients. This biomarker combined with NIHSS score can be used in place of more costly magnetic resonance imaging, with no loss of prediction accuracy.InterpretationThe new algorithm is more accurate, efficient, and accessible than its predecessors, which may support its use in clinical practice. While further work is needed to potentially incorporate sensory and cognitive factors, the algorithm can be used within days of stroke to provide accurate predictions of upper limb functional outcomes at 3 months after stroke. www.presto.auckland.ac.nz

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“…Nevertheless, some tests include a sensory assessment, e.g., in the FMT light touch and position sense is evaluated. The lack of specific tests for sensory or visual aspects is a major shortcoming across studies and recent findings show their importance for the recovery of upper limb function after stroke [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

Upper Limb Outcome Measures Used in Stroke Rehabilitation Studies: A Systematic Literature Review

et al. 2016

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BackgroundEstablishing which upper limb outcome measures are most commonly used in stroke studies may help in improving consensus among scientists and clinicians.ObjectiveIn this study we aimed to identify the most commonly used upper limb outcome measures in intervention studies after stroke and to describe domains covered according to ICF, how measures are combined, and how their use varies geographically and over time.MethodsPubmed, CinHAL, and PeDRO databases were searched for upper limb intervention studies in stroke according to PRISMA guidelines and477 studies were included.ResultsIn studies 48different outcome measures were found. Only 15 of these outcome measures were used in more than 5% of the studies. The Fugl-Meyer Test (FMT)was the most commonly used measure (in 36% of studies). Commonly used measures covered ICF domains of body function and activity to varying extents. Most studies (72%) combined multiple outcome measures: the FMT was often combined with the Motor Activity Log (MAL), the Wolf Motor Function Test and the Action Research Arm Test, but infrequently combined with the Motor Assessment Scale or the Nine Hole Peg Test. Key components of manual dexterity such as selective finger movements were rarely measured. Frequency of use increased over a twelve-year period for the FMT and for assessments of kinematics, whereas other measures, such as the MAL and the Jebsen Taylor Hand Test showed decreased use over time. Use varied largely between countries showing low international consensus.ConclusionsThe results showed a large diversity of outcome measures used across studies. However, a growing number of studies used the FMT, a neurological test with good psychometric properties. For thorough assessment the FMT needs to be combined with functional measures. These findings illustrate the need for strategies to build international consensus on appropriate outcome measures for upper limb function after stroke.

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Somatosensory Impairments in the Upper Limb Poststroke

Abstract: Somatosensory impairments are common in subacute patients poststroke and are related to motor outcome. Visuospatial neglect was associated with more severe upper-limb somatosensory impairments.

Cited by 67 publications

References 53 publications

Differences between left- and right-sided neglect revisited: A large cohort study across multiple domains

Differences between left- and right-sided neglect revisited: A large cohort study across multiple domains

PREP2: A biomarker‐based algorithm for predicting upper limb function after stroke

Upper Limb Outcome Measures Used in Stroke Rehabilitation Studies: A Systematic Literature Review

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