Oral Presentation Asia Pacific Stroke Conference 2024

Effect of somatosensory discrimination training of the upper limb within and across modalities - the CoNNECT Study. (107533)

Leeanne M Carey 1 2 , Brendon Haslam 1 2 , Yvonne Mak-Yuen 1 2 , Megan Turville 1 , Thomas A Matyas 1
  1. Occupational Therapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
  2. Neurorehabilitation and Recovery, The Florey, Melbourne, Victoria, Australia

Background/Aims: Effective therapies have been developed to treat somatosensory impairment after stroke. However, quantification and comparison of the magnitude of the training effect within and across modalities has not been systematically investigated. We aimed to quantify the magnitude of change associated with SENSe therapy, compare this across somatosensory modalities, investigate the impact of impairment severity, and quantify maintenance of gains in a new randomised controlled trial: CoNNECT.

Methods: Stroke survivors were assessed at least 3 months post-stroke and randomised into one of three treatment packages of 2 x 6-week intervention/no intervention phases. All received transfer-enhanced SENSe therapy. Outcome scores were normalised to permit comparison.

Results: Forty-two stroke survivors participated. A large magnitude of therapeutic change was obtained following SENSe therapy for texture discrimination (p=0.015; g=0.97) and limb position sense (p=0.031; g=0.65), with a smaller benefit for haptic object recognition that did not reach significance (p=0.069; g=0.37). Magnitude of improvement, pooled across groups, showed a 49% reduction in impairment for texture discrimination; a 40% reduction for proprioception; and 27% reduction for haptic object recognition. Therapy gains were significantly better for texture and limb position sense than object recognition. Treatment effect was associated with initial impairment severity and magnitude of gain was proportional. Gains were well maintained at follow-up.

Conclusion: SENSe therapy is effective, with the magnitude of effect varying across modalities. Initial impairment severity impacts outcome. Gains are proportional and well maintained. SENSe therapy is recommended, however individual differences in modality and impairment severity should be considered for targeted therapy outcomes.