The effectiveness of somatosensory retraining for improving sensory function in the arm following stroke: a systematic review

Abstract

The aim of this study was to evaluate if somatosensory retraining programmes assist people to improve somatosensory discrimination skills and arm functioning after stroke. Data sources: Nine databases were systematically searched: Medline, Cumulative Index to Nursing and Allied Health Literature, PsychInfo, Embase, Amed, Web of Science, Physiotherapy Evidence Database, OT seeker, and Cochrane Library. Review methods: Studies were included for review if they involved (1) adult participants who had somatosensory impairment in the arm after stroke, (2) a programme targeted at retraining somatosensation, (3) a primary measure of somatosensory discrimination skills in the arm, and (4) an intervention study design (e.g. randomized or non-randomized control designs). Results: A total of 6779 articles were screened. Five group trials and five single case experimental designs were included (N = 199 stroke survivors). Six studies focused exclusively on retraining somatosensation and four studies focused on somatosensation and motor retraining. Standardized somatosensory measures were typically used for tactile, proprioception, and haptic object recognition modalities. Sensory intervention effect sizes ranged from 0.3 to 2.2, with an average effect size of 0.85 across somatosensory modalities. A majority of effect sizes for proprioception and tactile somatosensory domains were greater than 0.5, and all but one of the intervention effect sizes were larger than the control effect sizes, at least as point estimates. Six studies measured motor and/or functional arm outcomes (n = 89 participants), with narrative analysis suggesting a trend towards improvement in arm use after somatosensory retraining. Conclusion: Somatosensory retraining may assist people to regain somatosensory discrimination skills in the arm after stroke.

Immediate effects of noxious and innocuous thermal stimulation on brain activation in patients with stroke

“…This phenomenon implies that noxious TS stimulated activity in both pain system pathways in patients with stroke to rewire motor function. [ 26 , 27 ] Interestingly, attention-related activation of the ACC and caudate were evoked by alternative TS between hot and cold pain temperature such as noxious TS design in this study. On the other hand, the activated responses occurred in multiple areas in the contralateral hemisphere of lesion, potentially pointing to functional compensation from the impairment of lesion hemisphere.…”

Gamifying Motor Rehabilitation Therapies: Challenges and Opportunities of Immersive Technologies

“…Among the advantages that immersive technologies might provide for therapies, proper sensory information for enhanced motor (re)learning is critical throughout the recovery process [39,40]. When the primary motor cortices are injured by stroke, the human brain is forced to remap its neural activity through mechanisms of neural reorganization and adaption.…”

Experiences of Upper Limb Somatosensory Retraining in Persons With Stroke: An Interpretative Phenomenological Analysis

“…Quantitative evidence shows somatosensory discrimination retraining can help people improve their sensation after stroke (Carey, 1993; Carey et al, 1993, 2011a; Yekutiel and Guttman, 1993; Byl et al, 2003, 2008; Carey and Matyas, 2005; Turville et al, 2019). For example, an active remedial approach to sensory discrimination retraining commonly involves learning-based tasks that focus on sensory discrimination and recognition skills (Yekutiel, 2000; Carey et al, 2011a).…”