Managing Somatosensory Impairments in Stroke: Current Clinical Practice and The Use of Technology

Research

Objectives: To identify current clinical practices and perspectives of physiotherapists and occupational therapists on the management of somatosensory impairment post-stroke, and the use of technology to objectively assess patient performance and deliver interventions.

Design: Questionnaire-based cross-sectional study.Setting: Acute hospitals, community hospitals, and day-rehabilitation centres.Participants: Licensed physiotherapists and occupational therapists (N = 132) with at least 1 year of clinical experience and were actively involved in stroke care within Singapore.Interventions: Not applicable.Main Outcome Measures: Perceptions, attitudes, and experiences measured by multiple-choice and 5-point Likert-scale questions, which included types of intervention, clinical assessment, and rehabilitation technology typically used in their daily practice.

Results: Most therapists (64.4%) spent no more than half of their clinical practice time per week on somatosensory interventions. Functional or task-specific training was primarily and regularly applied as an intervention for improving somatosensory functions post-stroke. Less than half (43.2%) reported using standardised assessments, with the sensory subscale of the Fugl-Meyer Assessment being the most frequently used, followed by the Nottingham Sensory Assessment. In comparison, the vast majority (97.7%) reported using non-standardised forms of assessment. While most therapists (86.2%) used technology to deliver interventions, technology adoption in clinical assessment was relatively scarce (30.3%). They believed that robotic technology combined with conventional therapy has the potential to optimise stroke rehabilitation, particularly for retraining proprioception. Price (89.4%), ease of use (73.5%), and lack of available space (68.9%) were identified as the major barriers to technology integration in clinical practice.

Conclusions: Somatosensory-specific interventions and standardised assessments were rarely implemented in clinical practice. Technology was more widely used for intervention, compared to assessment. These findings help inform policymakers to provide more standardised clinical guidelines related to the management of somatosensory impairments, and for relevant stakeholders to consider barriers to integrating technology in stroke rehabilitation.Author(s) Disclosures: No competing interests.