How do somatosensory deficits in the arm and hand relate to upper limb impairment, activity, and participation problems after stroke? A systematic review.
BACKGROUND
The association between somatosensory impairments and outcome after stroke remains unclear.


OBJECTIVE
The aim of this study was to systematically review the available literature on the relationship between somatosensory impairments in the upper limb and outcome after stroke.


METHODS
The electronic databases PubMed, CINAHL, EMBASE, Cochrane Library, PsycINFO, and Web of Science were systematically searched from inception until July 2013.


METHODS
Studies were included if adult patients with stroke (minimum n=10) were examined with reliable and valid measures of somatosensation in the upper limb to investigate the relationship with upper limb impairment, activity, and participation measures. Exclusion criteria included measures of somatosensation involving an overall score for upper and lower limb outcome and articles including only lower limb outcomes.


METHODS
Eligibility assessment, data extraction, and quality evaluation were completed by 2 independent reviewers. A cutoff score of ≥65% of the maximal quality score was used for further inclusion in this review.


RESULTS
Six articles met all inclusion criteria. Two-point discrimination was shown to be predictive for upper limb dexterity, and somatosensory evoked potentials were shown to have predictive value in upper limb motor recovery. Proprioception was significantly correlated with perceived level of physical activity and social isolation and had some predictive value in functional movements of the upper limb. Finally, the combination of light touch and proprioception impairment was shown to be significantly related to upper limb motor recovery as well as handicap situations during activities of daily living.


CONCLUSIONS
Heterogeneity of the included studies warrants caution when interpreting results.


CONCLUSIONS
Large variation in results was found due to heterogeneity of the studies. However, somatosensory deficits were shown to have an important role in upper limb motor and functional performance after stroke.
S. Meyer, MSc, Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven, Tervuursevest 101, Bus 1501, 3001 Heverlee, Belgium. sarah.meyer@faber.kuleuven.be.
Sarah
S
Meyer
A.H. Karttunen, MSc, Department of Health Sciences, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
Auli H
AH
Karttunen
V. Thijs, PhD, Department of Neurosciences, Faculty of Medicine, and Experimental Neurology and Leuven Research Institute for Neuroscience and Disease (LIND), KU Leuven; Laboratory of Neurobiology, Vesalius Research Center, Leuven, Belgium; and Department of Neurology, University Hospital Leuven, Leuven, Belgium.
Vincent
V
Thijs
H. Feys, PhD, Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven.
Hilde
H
Feys
G. Verheyden, PhD, Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven.
Geert
G
Verheyden
D000203:Activities of Daily Living; D000328:Adult; D006801:Humans; D020127:Recovery of Function; D020886:Somatosensory Disorders / Q000209:etiology* / Q000503:physiopathology / Q000534:rehabilitation*; D020521:Stroke / Q000150:complications*; D000071939:Stroke Rehabilitation; D034941:Upper Extremity / Q000503:physiopathology*