Rehabilitation of Somatic Sensation and Related Deficit of Motor Control in Patients with Pure Sensory Stroke

Nicola Smania, Barbara Montagnana, Silvia Faccioli, Antonio Fiaschi, Salvatore M. Aglioti

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To assess the effectiveness of a rehabilitative training program for deficits in somatic sensation and motor control of the hand in patients with pure sensory stroke. Design: Multiple baseline and before-after follow-up trial with behavioral analysis of single cases. Setting: Rehabilitation unit of a university hospital in Italy. Participants: Four patients were studied: 2 had a unilateral lesion confined to the parietal lobe (patients 1, 2), and 2 had a unilateral lesion of the thalamus (patients 3, 4) that also lapped the posterior limb of the internal capsule. All 4 patients had chronic deficits in somatic sensation and motor control of the contralesional hand. Intervention: Behavioral training consisting of exercises aimed at improving somatic sensation and motor control of the affected, contralesional hand. Thirty treatment sessions, each lasting 50 minutes, were performed. Main Outcome Measures: Somatic deficit was evaluated with 5 tests, and motor control deficit was assessed with 4 tests. One functional test estimated the influence of somatic deficit on daily activities. A visual analog scale (VAS) was also submitted to the patients' relatives to evaluate the amount of use of the affected arm in daily life activities. A baseline was obtained by recording each measure, except for the VAS, 4 times at the first evaluation session. Evaluation sessions were conducted before, after, and 6 months after the end of the experimental treatment. Results: All patients showed a stable baseline in at least 8 of the outcome measures. Patients 1 and 2 significantly improved in 9 and 7 outcome measures, respectively. Patients 3 and 4 improved in 4 and 7 outcome measures, respectively. With the exception of case 3, all patients considerably increased their use of the affected arm during daily life. The improvement was generally stable over a 6-month period, suggesting that the treatment had a long-term effect. Conclusions: Results suggest the possible effectiveness of our training program for treating somatic and motor control deficits of the hand in patients with cortical or subcortical pure sensory stroke.

Original languageEnglish
Pages (from-to)1692-1702
Number of pages11
JournalArchives of Physical Medicine and Rehabilitation
Volume84
Issue number11
DOIs
Publication statusPublished - Nov 2003

Keywords

  • Cerebrovascular disorders
  • Hand
  • Rehabilitation
  • Sensation

ASJC Scopus subject areas

  • Rehabilitation

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