The effect of sensory discrimination training on sensorimotor performance in individuals with central neurological conditions: A systematic review

Abstract

Objective The aim of this systematic review was to investigate the efficacy of sensory discrimination training (SDT) on sensorimotor performance in individuals with a neurological condition affecting the central nervous system. Methods MEDLINE, CINAHL, EMBASE, AMED, CENTRAL, PsychINFO, Scopus, OT Seeker, PEDro, ETHOS, Web of Science and OpenGrey were systematically searched for appropriate randomised controlled trials (RCTs). Included studies were assessed for risk of bias, and the quality of the evidence was rated using the GRADE approach. The protocol was registered on PROSPERO (CRD42017055237). Results Six RCTs met the inclusion/exclusion criteria. All studies used manual tactile discrimination to retrain somatosensation. Somatosensory effect sizes (0.12–0.92) and motor function effect sizes (0.12–10.39) ranged from trivial to large with narrative analysis revealing some between-group difference in favour of the intervention group. However, the total sample size ( n = 220) was relatively small, and the quality of the included studies was low. Conclusions SDT may have potential to be an efficacious treatment option for improving sensorimotor performance in individuals with neurological disease. However, at present there is limited evidence on which to base any firm clinical recommendations.

Enhancing touch sensibility by sensory retraining in a sensory discrimination task via haptic rendering

“…Stroke is the most common acquired brain injury that causes persisting and long-term disability in adults ( 1 ). Between 65 and 85% of stroke survivors suffer from somatosensory impairment ( 2 , 3 ), hampering individuals' ability to interpret somatosensory information ( 4 ), and thus, their ability to perform skillful movements independently ( 5 , 6 ). Importantly, somatosensory impairment increases patients' hospitalization time ( 7 ) and limits the recovery of sensorimotor function ( 8 ).…”

“…Somatosensory interventions have shown promising results in enhancing sensory discrimination—i.e., the skill to discern and interpret specific sensory stimuli ( 12 )—in stroke survivors ( 6 ). Moreover, sensory retraining interventions have been found beneficial for the recovery of motor function in stroke patients ( 9 ) and improvement of somatosensory function, especially those interventions based on the discrimination of textures, proprioceptive discrimination tests, and tactile object recognition ( 14 – 16 ).…”

“…Moreover, sensory retraining interventions have been found beneficial for the recovery of motor function in stroke patients ( 9 ) and improvement of somatosensory function, especially those interventions based on the discrimination of textures, proprioceptive discrimination tests, and tactile object recognition ( 14 – 16 ). Yet, in the last decade, six reviews concluded that there is insufficient empirical evidence regarding the effectiveness of sensory retraining interventions on the recovery of sensorimotor function after a brain injury ( 5 , 6 , 9 , 11 , 13 , 17 ). These reviews cited poor quality of study designs, variations in outcome measurements ( 18 ), small sample sizes, and inadequate statistical power to detect meaningful differences between control and treatment ( 6 ) as limiting factors to draw clear conclusions.…”

“…Yet, in the last decade, six reviews concluded that there is insufficient empirical evidence regarding the effectiveness of sensory retraining interventions on the recovery of sensorimotor function after a brain injury ( 5 , 6 , 9 , 11 , 13 , 17 ). These reviews cited poor quality of study designs, variations in outcome measurements ( 18 ), small sample sizes, and inadequate statistical power to detect meaningful differences between control and treatment ( 6 ) as limiting factors to draw clear conclusions. Two recent reviews about the effectiveness of somatosensory interventions concluded that high-quality research is necessary to determine whether sensory retraining is effective in stroke rehabilitation ( 9 , 11 ).…”

“…Quantitative reliable assessment of the sensorimotor performance is needed to evaluate if patients are achieving functional rehabilitation gains after somatosensory interventions ( 6 , 17 ). However, conventional somatosensory assessments may present variations in results, especially when the assessment is performed by different clinicians ( 19 ).…”