Limitations in utilization and prioritization of standardized somatosensory assessments after stroke: A cross-sectional survey of neurorehabilitation clinicians

Hoh, Joanna Eskander; Borich, Michael R.; Kesar, Trisha M.; Reisman, Darcy S.; Semrau, Jennifer A.

Limitations in utilization and prioritization of standardized somatosensory assessments after stroke: A cross-sectional survey of neurorehabilitation clinicians

Date

2023-04-16

Authors

Publisher

Topics in Stroke Rehabilitation

Abstract

Background and Purpose Somatosensory impairments are common after stroke, but receive limited evaluation and intervention during neurorehabilitation, despite negatively impacting functional movement and recovery. Objectives Our objective was to understand the scope of somatosensory assessments used by clinicians in stroke rehabilitation, and barriers to increasing use in clinical practice. Methods An electronic survey was distributed to clinicians (physical therapists, occupational therapists, physicians, and nurses) who assessed at least one individual with stroke in the past 6 months. The survey included questions on evaluation procedures, type, and use of somatosensory assessments, as well as barriers and facilitators in clinical practice. Results Clinicians (N = 431) indicated greater familiarity with non-standardized assessments, and greater utilization compared to standardized assessments (p < 0.0001). Components of tactile sensation were the most commonly assessed modality of somatosensation (25%), while proprioception was rarely assessed (1%). Overall, assessments of motor function were prioritized over assessments of somatosensory function (p < 0.0001). Discussion Respondents reported assessing somatosensation less frequently than motor function and demonstrated a reliance on rapid and coarse non-standardized assessments that ineffectively capture multi-modal somatosensory impairments, particularly for proprioceptive deficits common post-stroke. In general, clinicians were not familiar with standardized somatosensory assessments, and this knowledge gap likely contributes to lack of translation of these assessments into practice. Conclusions Clinicians utilize somatosensory assessments that inadequately capture the multi-modal nature of somatosensory impairments in stroke survivors. Addressing barriers to clinical translation has the potential to increase utilization of standardized assessments to improve the characterization of somatosensory deficits that inform clinical decision-making toward enhancing stroke rehabilitation outcomes.

Description

This is an Accepted Manuscript of an article published by Taylor & Francis in Topics in Stroke Rehabilitation on 04/16/2023, available at: https://doi.org/10.1080/10749357.2023.2200304. This article will be embargoed until 04/16/2024.

Keywords

stroke, somatosensation, proprioception, clinical assessment, neurorehabilitation

Citation

Hoh, Joanna Eskander, Michael R. Borich, Trisha M. Kesar, Darcy S. Reisman, and Jennifer A. Semrau. “Limitations in Utilization and Prioritization of Standardized Somatosensory Assessments after Stroke: A Cross-Sectional Survey of Neurorehabilitation Clinicians.” Topics in Stroke Rehabilitation, April 16, 2023, 1–15. https://doi.org/10.1080/10749357.2023.2200304.