Is Recovery of Somatosensory Impairment Conditional for Upper-Limb Motor Recovery Early After Stroke?
Sarah B Zandvliet, Gert Kwakkel, Rinske H M Nijland and 2 others
PMID 32391744WHAT IT FOUND
Upper-limb motor and somatosensory recovery tracked together early after stroke, but the link disappeared once time since stroke was considered.
Severe baseline sensory loss was not clearly linked to poorer motor recovery.
Key findings
01Upper-limb motor and somatosensory scores were associated over time, but the association was no longer significant after adjusting for progress of time.
02Baseline somatosensory impairment level did not significantly change the longitudinal motor-sensory association.
03The motor-sensory association differed by motor recovery pattern: recoverers showed a positive association, while non-recoverers showed a negative association.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
This was an observational association study, not a treatment trial, so it cannot show that somatosensory recovery caused motor recovery. The main model used 94 of the 215 patients, and the recoverer/non-recoverer subgroup used 60 patients, split into 21 recoverers and 39 non-recoverers. The EmNSA-UE is subjective, has no established smallest detectable change, and can be hard to score in patients with cognitive or attention impairments. The analysis could not adjust for lesion volume or location, and treatment type was not explicitly accounted for. The motor-sensory association disappeared after adjusting for progress of time, so the result may reflect shared recovery over time rather than a direct relationship.
Declared interests
The authors declared no potential conflicts of interest. Funding came from the Brain Foundation Netherlands, a European advanced grant, and ZonMw; the funder named was the European Commission.
The easy way to misread this
Do not conclude that sensory retraining will improve motor recovery. The study did not test treatment, and the motor-sensory association disappeared after adjusting for progress of time.