Impact of Somatosensory Training on Neural and Functional Recovery of Lower Extremity in Patients with Chronic Stroke: A Single Blind Controlled Randomized Trial

A rehabilitative approach beyond the acute stroke event: a scoping review about functional recovery perspectives in the chronic hemiplegic patient

Background

Stroke is a main cause of disability worldwide and its neuro-rehabilitative management is not limited to the acute phase but requires continuity in the rehabilitation approach especially in the chronic phase. The aim of this scoping review was to highlight the different treatment opportunities available in neurorehabilitation, effective for patients with chronic stroke sequelae, not only in terms of maintaining motor function but also improving it.

Methods

The literature search was conducted using the following databases: MEDLINE (PubMed), PEDro, Scopus, Web of Science (WOS), Cochrane from 2012 to February 2023. We selected Randomized Clinical Trials in English dealing with neurorehabilitation strategies in chronic hemiplegic patients after stroke focusing on motor function, muscular strength, gait, postural balance, spasticity, and quality of life.

Results

According to the inclusion criteria, 47 articles were selected for our review. All of them were analyzed following the primary outcome and the rehabilitation technique used. Despite the different protocols used within the same technique and despite the chronicity of the disease, all studies report an improvement after the rehabilitation treatment of motor function and quality of life.

Conclusion

The literature analyzed invites us to reflect respect to neurorehabilitation approach to the patient with chronic stroke sequelae often considered to have as its objective the maintenance of the present motor function and contain disability: instead, the review reports how, even in chronicity, the patient always reports margins of statistically and clinically significant improvement. The chronic stroke rehabilitation over 6 months has been proved effective in obtaining recovery in different settings.

Effects of proprioceptive training for people with stroke: A meta-analysis of randomized controlled trials

OBJECTIVE

To evaluate the effectiveness of proprioceptive training on balance performance, trunk control, and gait speed in people with stroke.

METHODS

We searched PubMed, Science Direct, Cochrane, Embase, and Medline for randomized controlled trials that evaluated the effects of proprioceptive training for patients with stroke from the date of each database's inception to July 26, 2021. Two reviewers independently screened the titles and abstracts of potentially eligible articles that were identified on the basis of the search criteria. Methodological quality was determined using version 2 of the Cochrane risk of bias tool for randomized trials. Data were analyzed using Comprehensive Meta-Analysis software. The treatment effect was estimated by calculating Hedges' g and 95% confidence intervals (CIs) using a random-effects model. Statistical heterogeneity was assessed according to the I² value. The primary outcome was balance performance and secondary outcomes were trunk control, gait speed, and basic functional mobility.

RESULTS

In total, 17 trials involving 447 people with stroke were included. Proprioceptive training had a significant effect on balance performance (Hedges' g = 0.69, 95% CI = 0.36-1.01), gait speed (Hedges' g = 0.57, 95% CI = 0.19-0.94), trunk control (Hedges' g = 0.75, 95% CI = 0.33-1.17), and basic functional mobility (Hedges' g = 0.63, 95% CI = 0.31-0.94) among people with stroke.

CONCLUSION

Proprioceptive training may be effective in improving balance performance, gait speed, trunk control, and basic functional mobility among people with stroke.