Deans' stroke musings: Associations Between Sensorimotor Impairments in the Upper Limb at 1 Week and 6 Months After Stroke

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Friday, May 27, 2016

Associations Between Sensorimotor Impairments in the Upper Limb at 1 Week and 6 Months After Stroke

Ask your doctor if this follows the same recommendations written about by Margaret Yekutiel in the book, Sensory Re-Education of the Hand After Stroke in 2001. Better sensation leads to better motor recovery. Do all different types of sensation, hot, cold, touch, pressure, etc.
http://mobile.journals.lww.com/jnpt/_layouts/15/oaks.journals.mobile/articleviewer.aspx?year=9000&issue=00000&article=99813

Meyer, Sarah PhD; De Bruyn, Nele BSc; Krumlinde-Sundholm, Lena PhD; Peeters, Andre MD; Feys, Hilde PhD; Thijs, Vincent PhD; Verheyden, Geert PhD

Journal of Neurologic Physical Therapy
Post Author Corrections: May 20, 2016
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Abstract

Background and Purpose: Longitudinal information regarding the prevalence of upper limb somatosensory deficits and the association with motor impairment and activity limitations is scarce. The aim of this prospective cohort study was to map the extent and distribution of somatosensory deficits, and to determine associations over time between somatosensory deficits and motor impairment and activity limitations.

Methods: We recruited 32 participants who were assessed 4 to 7 days after stroke, and reassessed at 6 months. Somatosensory measurements included the Erasmus-modified Nottingham sensory assessment (Em-NSA), perceptual threshold of touch, thumb finding test, 2-point discrimination, and stereognosis subscale of the NSA. Evaluation of motor impairment comprised the Fugl-Meyer assessment, Motricity Index, and Action Research Arm Test. In addition, at 6 months, activity limitation was determined using the adult assisting hand assessment stroke, the ABILHAND, and hand subscale of the Stroke Impact Scale.

Results: Somatosensory impairments were common, with 41% to 63% experiencing a deficit in one of the modalities within the first week and 3% to 50% at 6 months. In the acute phase, there were only very low associations between somatosensory and motor impairments (r = 0.03-0.20), whereas at 6 months, low to moderate associations (r = 0.32-0.69) were found for perceptual threshold of touch, thumb finding test, and stereognosis with motor impairment and activity limitations. Low associations (r = 0.01-0.29) were found between somatosensory impairments in the acute phase and motor impairments and activity limitations at 6 months.

Discussion and Conclusions: This study showed that somatosensory impairments are common and suggests that the association with upper limb motor and functional performance increases with time after stroke.

Video Abstract available for more insights from the authors (see Supplemental Digital Content 1, http://links.lww.com/JNPT/A138).