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The Prevalence and Magnitude of Impaired Cutaneous Sensation across the Hand in the Chronic Period Post-Stroke

Sensation is commonly impaired immediately post-stroke but little is known about the long-term changes in cutaneous sensation that have the capacity to adversely impact independence and motor-function. We investigated cutaneous sensory thresholds across the hand in the chronic post-stroke period. Cu...

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Autores principales: Bowden, Jocelyn L., Lin, Gaven G., McNulty, Penelope A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4133225/
https://www.ncbi.nlm.nih.gov/pubmed/25121607
http://dx.doi.org/10.1371/journal.pone.0104153
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author Bowden, Jocelyn L.
Lin, Gaven G.
McNulty, Penelope A.
author_facet Bowden, Jocelyn L.
Lin, Gaven G.
McNulty, Penelope A.
author_sort Bowden, Jocelyn L.
collection PubMed
description Sensation is commonly impaired immediately post-stroke but little is known about the long-term changes in cutaneous sensation that have the capacity to adversely impact independence and motor-function. We investigated cutaneous sensory thresholds across the hand in the chronic post-stroke period. Cutaneous sensation was assessed in 42 community-dwelling stroke patients and compared to 36 healthy subjects. Sensation was tested with calibrated monofilaments at 6 sites on the hand that covered the median, ulnar and radial innervation territories and included both glabrous (hairless) and hairy skin. The motor-function of stroke patients was assessed with the Wolf Motor Function Test and the upper-limb motor Fugl-Meyer Assessment. Impaired cutaneous sensation was defined as monofilament thresholds >3 SD above the mean of healthy subjects and good sensation was ≤3 SD. Cutaneous sensation was impaired for 33% of patients and was 40–84% worse on the more-affected side compared to healthy subjects depending on the site (p<0.05). When the stroke patient data were pooled cutaneous sensation fell within the healthy range, although ∼1/3 of patients were classified with impaired sensation. Classification by motor-function revealed low levels of impaired sensation. The magnitude of sensory loss was only apparent when the sensory-function of stroke patients was classified as good or impaired. Sensation was most impaired on the dorsum of the hand where age-related changes in monofilament thresholds are minimal in healthy subjects. Although patients with both high and low motor-function had poor cutaneous sensation, overall patients with low motor-function had poorer cutaneous sensation than those with higher motor-function, and relationships were found between motor impairments and sensation at the fingertip and palm. These results emphasize the importance of identifying the presence and magnitude of cutaneous sensory impairments in the chronic period after stroke.
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spelling pubmed-41332252014-08-19 The Prevalence and Magnitude of Impaired Cutaneous Sensation across the Hand in the Chronic Period Post-Stroke Bowden, Jocelyn L. Lin, Gaven G. McNulty, Penelope A. PLoS One Research Article Sensation is commonly impaired immediately post-stroke but little is known about the long-term changes in cutaneous sensation that have the capacity to adversely impact independence and motor-function. We investigated cutaneous sensory thresholds across the hand in the chronic post-stroke period. Cutaneous sensation was assessed in 42 community-dwelling stroke patients and compared to 36 healthy subjects. Sensation was tested with calibrated monofilaments at 6 sites on the hand that covered the median, ulnar and radial innervation territories and included both glabrous (hairless) and hairy skin. The motor-function of stroke patients was assessed with the Wolf Motor Function Test and the upper-limb motor Fugl-Meyer Assessment. Impaired cutaneous sensation was defined as monofilament thresholds >3 SD above the mean of healthy subjects and good sensation was ≤3 SD. Cutaneous sensation was impaired for 33% of patients and was 40–84% worse on the more-affected side compared to healthy subjects depending on the site (p<0.05). When the stroke patient data were pooled cutaneous sensation fell within the healthy range, although ∼1/3 of patients were classified with impaired sensation. Classification by motor-function revealed low levels of impaired sensation. The magnitude of sensory loss was only apparent when the sensory-function of stroke patients was classified as good or impaired. Sensation was most impaired on the dorsum of the hand where age-related changes in monofilament thresholds are minimal in healthy subjects. Although patients with both high and low motor-function had poor cutaneous sensation, overall patients with low motor-function had poorer cutaneous sensation than those with higher motor-function, and relationships were found between motor impairments and sensation at the fingertip and palm. These results emphasize the importance of identifying the presence and magnitude of cutaneous sensory impairments in the chronic period after stroke. Public Library of Science 2014-08-14 /pmc/articles/PMC4133225/ /pubmed/25121607 http://dx.doi.org/10.1371/journal.pone.0104153 Text en © 2014 Bowden et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Bowden, Jocelyn L.
Lin, Gaven G.
McNulty, Penelope A.
The Prevalence and Magnitude of Impaired Cutaneous Sensation across the Hand in the Chronic Period Post-Stroke
title The Prevalence and Magnitude of Impaired Cutaneous Sensation across the Hand in the Chronic Period Post-Stroke
title_full The Prevalence and Magnitude of Impaired Cutaneous Sensation across the Hand in the Chronic Period Post-Stroke
title_fullStr The Prevalence and Magnitude of Impaired Cutaneous Sensation across the Hand in the Chronic Period Post-Stroke
title_full_unstemmed The Prevalence and Magnitude of Impaired Cutaneous Sensation across the Hand in the Chronic Period Post-Stroke
title_short The Prevalence and Magnitude of Impaired Cutaneous Sensation across the Hand in the Chronic Period Post-Stroke
title_sort prevalence and magnitude of impaired cutaneous sensation across the hand in the chronic period post-stroke
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4133225/
https://www.ncbi.nlm.nih.gov/pubmed/25121607
http://dx.doi.org/10.1371/journal.pone.0104153
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