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Explicit versus implicit lower extremity sensory retraining for post-stroke chronic sensory deficits: a randomized
Hadas Ofek1,2, Mordechai Alperin3, Tsipi Knoll3
1Department of Physical Therapy, School of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.
Disability and Rehabilitation
|June 1, 2022
Summary
Both explicit sensory retraining and implicit repeated exposure effectively improved balance and gait in stroke survivors with sensory impairment. These sensory rehabilitation methods are easily implemented in outpatient clinics, leading to significant functional gains.
Area of Science:
- Neurorehabilitation
- Physical Therapy
- Stroke Recovery
Background:
- Sensory impairment following a stroke significantly hinders the rehabilitation of balance and gait.
- Effective sensory retraining strategies are crucial for improving functional outcomes in individuals with chronic post-stroke deficits.
Purpose of the Study:
- To compare the efficacy of explicit sensory retraining (ESR) versus implicit repeated exposure (IRE) in improving sensation, balance, and gait.
- To assess the impact of these sensory interventions on mobility and participation in individuals with chronic post-stroke sensory impairment.
Main Methods:
- A double-blind, multicenter randomized controlled trial involving 64 participants with chronic post-stroke sensory impairment.
- Participants received 10 sessions of either ESR or IRE, with outcomes measured for sensation, balance, mobility, and participation.
Main Results:
- Both ESR and IRE interventions resulted in clinically meaningful improvements (10-31%) across various outcome measures.
- No significant differences were found between the ESR and IRE groups, indicating comparable efficacy.
- The effect size for the time effect was notable, reaching 0.63 for the miniBEST balance scale.
Conclusions:
- Both explicit and implicit sensory-focused training protocols are effective in improving lower extremity function, balance, and gait in stroke survivors.
- These sensory rehabilitation treatments are readily implementable in outpatient settings and yield significant functional improvements.
- Structured, sensory-focused training offers a viable approach to enhance balance and gait in individuals with chronic post-stroke sensory deficits.
