A Network of Sites and Upskilled Therapists to Deliver Best-Practice Stroke Rehabilitation of the Arm: Protocol for a Knowledge Translation Study.

Implementation of evidence-informed rehabilitation of the upper limb is variable, and outcomes for stroke survivors are often suboptimal. We established a national partnership of clinicians, survivors of stroke, researchers, healthcare organizations, and policy makers to facilitate change. The objectives of this study are to increase access to best-evidence rehabilitation of the upper limb and improve outcomes for stroke survivors.

Calibration of Impairment Severity to Enable Comparison across Somatosensory Domains.

Comparison across somatosensory domains, important for clinical and scientific goals, requires prior calibration of impairment severity. Provided test score distributions are comparable across domains, valid comparisons of impairment can be made by reference to score locations in the corresponding distributions (percentile rank or standardized scores). However, this is often not the case.

Characterizing Touch Discrimination Impairment from Pooled Stroke Samples Using the Tactile Discrimination Test: Updated Criteria for Interpretation and Brief Test Version for Use in Clinical Practice Settings.

Somatosensory loss post-stroke is common, with touch sensation characteristically impaired. Yet, quantitative, standardized measures of touch discrimination available for clinical use are currently limited. We aimed to characterize touch impairment and re-establish the criterion of abnormality of the Tactile Discrimination Test (TDT) using pooled data and to determine the sensitivity and specificity of briefer test versions.

The Functional Tactile Object Recognition Test: A Unidimensional Measure With Excellent Internal Consistency for Haptic Sensing of Real Objects After Stroke.

Introduction: Our hands, with their exquisite sensors, work in concert with our sensing brain to extract sensory attributes of objects as we engage in daily activities. One in two people with stroke experience impaired body sensation, with negative impact on hand use and return to previous valued activities. Valid, quantitative tools are critical to measure somatosensory impairment after stroke.

Measures of maximal tactile pressures of a sustained grasp task using a TactArray device have satisfactory reliability and validity in healthy people.

To investigate the reliability and the concurrent validity of maximal tactile pressures and forces of a sustained grasp task using a TactArray device in healthy adults. Healthy participants ( = 18, mean age: 62.2 ± 9.

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

Objective: 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.

Initial severity of somatosensory impairment influences response to upper limb sensory retraining post-stroke.

Background: Somatosensory loss occurs often following stroke. A proportional recovery model is proposed for spontaneous motor recovery, with implication for treatment planning. It is currently unknown if initial severity of sensory impairment influences stroke survivors' response to treatment to improve sensation.

Effects of Somatosensory Impairment on Participation After Stroke.

Objective: Our objective was to determine the effect of loss of body sensation on activity participation in stroke survivors.

Method: Participants (N = 268) were assessed at hospital admission for somatosensory and motor impairment using the National Institutes of Health Stroke Scale. Participation was assessed using the Activity Card Sort (ACS) in the postacute phase.

Change in Functional Arm Use Is Associated With Somatosensory Skills After Sensory Retraining Poststroke.

Objective: We investigated changes in functional arm use after retraining for stroke-related somatosensory loss and identified whether such changes are associated with somatosensory discrimination skills.

Method: Data were pooled (N = 80) from two randomized controlled trials of somatosensory retraining. We used the Motor Activity Log to measure perceived amount of arm use in daily activities and the Action Research Arm Test to measure performance capacity.

The Right Supramarginal Gyrus Is Important for Proprioception in Healthy and Stroke-Affected Participants: A Functional MRI Study.

Human proprioception is essential for motor control, yet its central processing is still debated. Previous studies of passive movements and illusory vibration have reported inconsistent activation patterns related to proprioception, particularly in high-order sensorimotor cortices. We investigated brain activation specific to proprioception, its laterality, and changes following stroke.

Stress reactivity and the Hemodynamic Profile-Compensation Deficit (HP-CD) Model of blood pressure regulation.

Considering the central role of the concept of blood pressure reactivity to explanations of the influence of life stress in the pathogenesis of cardiovascular disease, it is important that the underlying psychophysiological determinants of blood pressure change are elucidated. Empirical evidence is reviewed concerning the utility of the Hemodynamic Profile-Compensation Deficit (HP-CD) Model (Gregg et al., 2002), which draws on physiological theory that explains blood pressure regulation as a dynamic compensatory relation between cardiac output and total peripheral resistance.

SENSe: Study of the Effectiveness of Neurorehabilitation on Sensation: a randomized controlled trial.

Background: Sensory loss is common after stroke, with negative impact on exploration of the immediate environment, hand function, and return to daily activities.

Objective: To compare the effectiveness of a perceptual-learning based sensory discrimination program versus non-specific exposure to sensory stimuli via passive movements and grasping of common objects.

Methods: The authors conducted a randomized parallel-group controlled trial, with blinding of subjects, clinical assessors, and data analysts.

Frequency of discriminative sensory loss in the hand after stroke in a rehabilitation setting.

Objective: Somatosensory loss following stroke is common, with negative consequences for functional outcome. However, existing studies typically do not include quantitative measures of discriminative sensibility. The aim of this study was to quantify the proportion of stroke patients presenting with discriminative sensory loss of the hand in the post-acute rehabilitation phase.

Clinical measures of handgrip limitation relate to impaired pinch grip force control after stroke.

This study examined whether clinical measures of handgrip limitation relate to laboratory measures of grip force impairment during a pinch grip, lift, and hold task post-stroke. Handgrip ability in 45 people with stroke who had residual grip ability was examined relative to 45 age-matched healthy adults. The clinical tests included items from a) the Jebsen Taylor Hand Function Test; b) the Motor Assessment Scale; c) the Functional Independence Measure (FIM); and d) a custom-designed survey about hand-use in daily life.

Impaired discrimination of surface friction contributes to pinch grip deficit after stroke.

Background: Impaired sensation and force production could both contribute to handgrip limitation after stroke. Clinically, training is usually directed to motor impairment rather than sensory impairment despite the prevalence of sensory deficit and the importance of sensory input for grip control.

Objective: The aim of this study was to investigate if sensory deficits contribute to pinch grip dysfunction beyond that attributable to motor deficits poststroke.

Short-term relationships between footstep variables in young adults.

Autocorrelation analyses were used to quantify the short-term relationships between selected footstep variables during steady state, straight-line over-ground walking in 20 healthy young adults. The serial dependency for step length, step time, heel to heel base of support (HHBS) and double limb support time were examined for a minimum of six consecutive steps using an 8.3m GAITRite analysis system.

Grip force regulation during pinch grip lifts under somatosensory guidance: comparison between people with stroke and healthy controls.

Objectives: To compare the timing and grip force application in a pinch grip task performed under somatosensory guidance in stroke and matched controls and to identify characteristics of impaired grip force regulation after stroke.

Design: Matched-pairs control group.

Setting: University research laboratory.

Association between hemodynamic profile during laboratory stress and ambulatory pulse pressure.

Hemodynamic responses underlying blood pressure reactivity to laboratory stress are theoretically linked to cardiovascular pathophysiology. The present study investigated whether a vascular response predicted ambulatory pulse pressure, a known risk factor for cardiovascular disease. A new model of hemodynamic profile, previously developed by the authors, was applied to 24-h ambulatory data from 30 female and 34 male healthy young adults.

Training of somatosensory discrimination after stroke: facilitation of stimulus generalization.

Objective: Task-specific learning typifies perceptual training but limits rehabilitation of sensory deficit after stroke. We therefore investigated spontaneous and procedurally facilitated transfer of training effects within the somatosensory domain after stroke.

Design: Ten single-case, multiple-baseline experiments were conducted with stroke participants who had impaired discrimination of touch or limb-position sense.

A new model of individual differences in hemodynamic profile and blood pressure reactivity.

A quantitative, theory-driven model of hemodynamics was developed, relating reactivity in blood pressure to orthogonal dimensions of "hemodynamic profile" and "compensation deficit," which were derived from the (multiplicative) interaction of cardiac output and total peripheral resistance. A Finapres 2300e was used to estimate blood pressure, cardiac output, and total peripheral resistance in 100 healthy men and women during mental arithmetic and cold pressor tasks on two occasions. Results were consistent with model predictions.

Evaluation of impaired fingertip texture discrimination and wrist position sense in patients affected by stroke: comparison of clinical and new quantitative measures.

Discriminative sensory loss is common following stroke but may not be adequately detected by routine clinical measures. Quantitative tests of texture discrimination and limb position sense have been recently developed. These tests provide reliable estimates of discrimination, differentiate impaired performance following stroke, and have standardized criteria of abnormality.

Quantification of physiotherapy treatment time in stroke rehabilitation - criterion-related validity.

Physiotherapists are required to record treatment time in both clinical research and daily practice. This study aimed to investigate the accuracy of treatment time records using a specific method of defining treatment for patients with stroke. Twenty-six physiotherapists provided time records using this method for one of their treatment sessions, each of which was videotaped.