Sensory loss in stroke patients: effective training of tactile and proprioceptive discrimination

Although somatosensory loss following stroke is common, with negative consequences for functional outcome, studies of existing somatosensory retraining programs are limited by theoretical weaknesses, poor methodology, and negative findings. We, therefore, developed a new program for stroke patients and investigated its effect on tactile discrimination in four AB, single-case quasi-experiments and its effect on tactile and proprioceptive discrimination in four multiple-baseline experiments. Training involved specific, graded discrimination tasks, attentive exploration of stimuli with vision occluded, deliberate anticipation, and quantitative feedback. Graphic and statistical interrupted time-series analyses indicated that treatment produced improvements in seven of eight tactile time series and all four proprioceptive time series. Baseline improvement in one tactile time series prevented unequivocal evaluation of treatment effect. Improvements were clinically significant, discrimination in the affected hand becoming comparable to the other hand and normal performance. Therapeutic effects were maintained at 3-month to 5-month follow-up tests.