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The Effects of Sensorial Functions on Motor Functions and Functional Assessments in Patients with Chronic Stroke

Received: 28 March 2018     Accepted: 15 April 2018     Published: 24 May 2018
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Abstract

Background: Sensory dysfunction following stroke is a common syndrome. Unless sensory dysfunction is assessed and defined, motor recovery will be limited due to focusing on motor performance during the rehabilitation and maximum outcomes will not be obtained for the treatment. Objective: To investigate the effect of sensory functions on motor function and functional status. Method: Sixty patients with chronic stroke hospitalized for rehabilitation of hemiplegia after stroke. Brunnstrom and Fugl-Meyer motor assesment scales to determine motor improvement were used, Functional independence measurement (FIM) was used for functional evaluation. Touching was used for superficial sensory assesment. Thumb localization and finger shift tests were used for deep sensorial assesment. Stereognosis and two-point discrimination tests were used for cortical sensory assesment. Partial localization-finger scrolling tests, stereognosis and two-point discrimination tests were evaluated for the deep sense and cortical senses of the patients. Result: Two point discrimination test result was 5-6 mm in 20 (33.3%) patient and 7 mm and abouve in 40 (66.7%) patients. Superficial sensory examination was found hipoesthetic in 50 patients (83.3%) and normal in 10 patients (16.7%). With the Two-point discrimination test, 20 patients (33.3%) were found to have a score of 5-to-6 mm’ s, and 40 patients were found to have a score of 7- more mm’ s. While proprioception was normal in 38 patients, in 22 patients was found to be mildly impaired by thumb localization test and finger shift test. 26 patients recognised 10 to 12 objects 15 patients recognised 7 to 9 objects and 19 patients recognised less than 7 objects by sterognazie assesment. There were statistically significant differences between superficial sense, Two-point discrimination, and sterognazie results and FIM, Brunnstrom upper-lower limb and Fugl-Meyer upper-lower values before and after hospitalization. Brunnstrom and Fugl-Meyer results were statistically significant according to Thumb localization test and finger shift test before and after hospitalization; however there was no difference according to FIM. Discussion: The findings of this study revealed that sensory dysfunctions were common after a stroke and affected motor and functional conditions of the patients. There is a significant relationship between motor functions and sensory functions in stroke patients. Assessment of sensory functions and early diagnosis will improve motor healing. Conclusion: A detailed examination of sensory functions and inclusion in the treatment program may be considered as an effective factor in improving motor function.

Published in International Journal of Neurologic Physical Therapy (Volume 4, Issue 2)
DOI 10.11648/j.ijnpt.20180402.11
Page(s) 29-33
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2018. Published by Science Publishing Group

Keywords

Stroke, Sensory Function, Motor Function

References
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[3] Carey LM. Somatosensory loss after stroke. Crit Rev Phys Rehabil Med. 1995; 7:51-91.
[4] Matyas F, Sreenivasan V, Marbach F, Wacongne C, Barsy B, Mateo C. et al. Motor control by sensory cortex. Science. 2010; 330(6008): 1240-1243.
[5] Bruce H. Dobkin The Clinical Science Of Neurologic Rehabilitation. Motor learning and recovery of function. Second Edition OXFORD Universty Pres. Oxford, UK, 2003
[6] Bartels MN. Pathophysiology and Medical Management of Stroke In: Gillen G, Burkhadt A editors, Stroke rehabilitation a function-based approach. 2nd ed. Philadelphia: Mosby; 2004.
[7] Kenzie JM, Semrau JA, Findlater SE, Herter TM, Hill MD, Scott SH. et al. Anatomical correlates of proprioceptive impairments following acute stroke: a case series. J Neurol Sci. 2014; 342(1): 52-61.
[8] Meyer S, Karttunen AH, Thijs V, Feys H, Verheyden G. How do somatosensory deficits in the arm and hand relate to upper limb impairment, activity, and participation problems after stroke? A systematic review. Phys Ther. 2014; 94(9): 1220-1231.
[9] Connell LA, McMahon NE, Adams N. Stroke survivors’ experiences of somatosensory impairment after stroke: An Interpretative Phenomenological Analysis. Physiotherapy, 2013; 100(2): 150-155.
[10] Connell LA, Lincoln NB, Radford KA. Somatosensory impairment after stroke: frequency of different deficits and their recovery. Clin Rehabil. 2008; 22(8): 758-767.
[11] Yalıman A, Eskiyurt N, Vural M, Dönmez M, Çeşme F, Demirci S ve ark. Serebrovasküler atak sonrası kognitif fonksiyon ve duygu-durum değişiklikleri. Türk Geriatri Dergisi 2004; 7:211-216.
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[15] Kim JS, Choi-Kwon S. Discriminative Sensory Dysfunction After Unilateral Stroke. Stroke; 1996; 27(4): 677-682.
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[17] Sawner K, LaVigne J. Brunnstrom's movement therapy in hemiplegia: a neurophysiological approach. Pennsylvania: JB Lippincott Company, 1992.
[18] Küçükdevci AA. İnmeli hastalarda fonksiyonel değerlendirme. Hemipleji ve Rehabilitasyonu sempozyum kitabı. Gazi Üniversitesi, Ankara 1999.
[19] O' Sullivan SB, Schmitz TJ eds. Physical rehabilitation: assessment and treatment. Philadelphia: FA Davis Co 2001.
[20] Aman JE, Elangovan N, Yeh IL, Konczak J. The effectiveness of proprioceptive training for improving motor function: a systematic review. Front Hum Neurosci. 2014; 8:1075.
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Cite This Article
  • APA Style

    Nuran Erden, Mustafa Aziz Yıldırım, Kadriye Öneş. (2018). The Effects of Sensorial Functions on Motor Functions and Functional Assessments in Patients with Chronic Stroke. International Journal of Neurologic Physical Therapy, 4(2), 29-33. https://doi.org/10.11648/j.ijnpt.20180402.11

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    ACS Style

    Nuran Erden; Mustafa Aziz Yıldırım; Kadriye Öneş. The Effects of Sensorial Functions on Motor Functions and Functional Assessments in Patients with Chronic Stroke. Int. J. Neurol. Phys. Ther. 2018, 4(2), 29-33. doi: 10.11648/j.ijnpt.20180402.11

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    AMA Style

    Nuran Erden, Mustafa Aziz Yıldırım, Kadriye Öneş. The Effects of Sensorial Functions on Motor Functions and Functional Assessments in Patients with Chronic Stroke. Int J Neurol Phys Ther. 2018;4(2):29-33. doi: 10.11648/j.ijnpt.20180402.11

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  • @article{10.11648/j.ijnpt.20180402.11,
      author = {Nuran Erden and Mustafa Aziz Yıldırım and Kadriye Öneş},
      title = {The Effects of Sensorial Functions on Motor Functions and Functional Assessments in Patients with Chronic Stroke},
      journal = {International Journal of Neurologic Physical Therapy},
      volume = {4},
      number = {2},
      pages = {29-33},
      doi = {10.11648/j.ijnpt.20180402.11},
      url = {https://doi.org/10.11648/j.ijnpt.20180402.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijnpt.20180402.11},
      abstract = {Background: Sensory dysfunction following stroke is a common syndrome. Unless sensory dysfunction is assessed and defined, motor recovery will be limited due to focusing on motor performance during the rehabilitation and maximum outcomes will not be obtained for the treatment. Objective: To investigate the effect of sensory functions on motor function and functional status. Method: Sixty patients with chronic stroke hospitalized for rehabilitation of hemiplegia after stroke. Brunnstrom and Fugl-Meyer motor assesment scales to determine motor improvement were used, Functional independence measurement (FIM) was used for functional evaluation. Touching was used for superficial sensory assesment. Thumb localization and finger shift tests were used for deep sensorial assesment. Stereognosis and two-point discrimination tests were used for cortical sensory assesment. Partial localization-finger scrolling tests, stereognosis and two-point discrimination tests were evaluated for the deep sense and cortical senses of the patients. Result: Two point discrimination test result was 5-6 mm in 20 (33.3%) patient and 7 mm and abouve in 40 (66.7%) patients. Superficial sensory examination was found hipoesthetic in 50 patients (83.3%) and normal in 10 patients (16.7%). With the Two-point discrimination test, 20 patients (33.3%) were found to have a score of 5-to-6 mm’ s, and 40 patients were found to have a score of 7- more mm’ s. While proprioception was normal in 38 patients, in 22 patients was found to be mildly impaired by thumb localization test and finger shift test. 26 patients recognised 10 to 12 objects 15 patients recognised 7 to 9 objects and 19 patients recognised less than 7 objects by sterognazie assesment. There were statistically significant differences between superficial sense, Two-point discrimination, and sterognazie results and FIM, Brunnstrom upper-lower limb and Fugl-Meyer upper-lower values before and after hospitalization. Brunnstrom and Fugl-Meyer results were statistically significant according to Thumb localization test and finger shift test before and after hospitalization; however there was no difference according to FIM. Discussion: The findings of this study revealed that sensory dysfunctions were common after a stroke and affected motor and functional conditions of the patients. There is a significant relationship between motor functions and sensory functions in stroke patients. Assessment of sensory functions and early diagnosis will improve motor healing. Conclusion: A detailed examination of sensory functions and inclusion in the treatment program may be considered as an effective factor in improving motor function.},
     year = {2018}
    }
    

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  • TY  - JOUR
    T1  - The Effects of Sensorial Functions on Motor Functions and Functional Assessments in Patients with Chronic Stroke
    AU  - Nuran Erden
    AU  - Mustafa Aziz Yıldırım
    AU  - Kadriye Öneş
    Y1  - 2018/05/24
    PY  - 2018
    N1  - https://doi.org/10.11648/j.ijnpt.20180402.11
    DO  - 10.11648/j.ijnpt.20180402.11
    T2  - International Journal of Neurologic Physical Therapy
    JF  - International Journal of Neurologic Physical Therapy
    JO  - International Journal of Neurologic Physical Therapy
    SP  - 29
    EP  - 33
    PB  - Science Publishing Group
    SN  - 2575-1778
    UR  - https://doi.org/10.11648/j.ijnpt.20180402.11
    AB  - Background: Sensory dysfunction following stroke is a common syndrome. Unless sensory dysfunction is assessed and defined, motor recovery will be limited due to focusing on motor performance during the rehabilitation and maximum outcomes will not be obtained for the treatment. Objective: To investigate the effect of sensory functions on motor function and functional status. Method: Sixty patients with chronic stroke hospitalized for rehabilitation of hemiplegia after stroke. Brunnstrom and Fugl-Meyer motor assesment scales to determine motor improvement were used, Functional independence measurement (FIM) was used for functional evaluation. Touching was used for superficial sensory assesment. Thumb localization and finger shift tests were used for deep sensorial assesment. Stereognosis and two-point discrimination tests were used for cortical sensory assesment. Partial localization-finger scrolling tests, stereognosis and two-point discrimination tests were evaluated for the deep sense and cortical senses of the patients. Result: Two point discrimination test result was 5-6 mm in 20 (33.3%) patient and 7 mm and abouve in 40 (66.7%) patients. Superficial sensory examination was found hipoesthetic in 50 patients (83.3%) and normal in 10 patients (16.7%). With the Two-point discrimination test, 20 patients (33.3%) were found to have a score of 5-to-6 mm’ s, and 40 patients were found to have a score of 7- more mm’ s. While proprioception was normal in 38 patients, in 22 patients was found to be mildly impaired by thumb localization test and finger shift test. 26 patients recognised 10 to 12 objects 15 patients recognised 7 to 9 objects and 19 patients recognised less than 7 objects by sterognazie assesment. There were statistically significant differences between superficial sense, Two-point discrimination, and sterognazie results and FIM, Brunnstrom upper-lower limb and Fugl-Meyer upper-lower values before and after hospitalization. Brunnstrom and Fugl-Meyer results were statistically significant according to Thumb localization test and finger shift test before and after hospitalization; however there was no difference according to FIM. Discussion: The findings of this study revealed that sensory dysfunctions were common after a stroke and affected motor and functional conditions of the patients. There is a significant relationship between motor functions and sensory functions in stroke patients. Assessment of sensory functions and early diagnosis will improve motor healing. Conclusion: A detailed examination of sensory functions and inclusion in the treatment program may be considered as an effective factor in improving motor function.
    VL  - 4
    IS  - 2
    ER  - 

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Author Information
  • Departman of Physiotherapy, Nisantasi University, Istanbul, Turkey

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