S. Meyer, MSc, Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven, Tervuursevest 101, Bus 1501, 3001 Heverlee, Belgium.
A.H. Karttunen, MSc, Department of Health Sciences, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
Phys Ther. 2014 Sep;94(9):1220-31. doi: 10.2522/ptj.20130271. Epub 2014 Apr 24.
The association between somatosensory impairments and outcome after stroke remains unclear.
The aim of this study was to systematically review the available literature on the relationship between somatosensory impairments in the upper limb and outcome after stroke.
The electronic databases PubMed, CINAHL, EMBASE, Cochrane Library, PsycINFO, and Web of Science were systematically searched from inception until July 2013.
Studies were included if adult patients with stroke (minimum n=10) were examined with reliable and valid measures of somatosensation in the upper limb to investigate the relationship with upper limb impairment, activity, and participation measures. Exclusion criteria included measures of somatosensation involving an overall score for upper and lower limb outcome and articles including only lower limb outcomes.
Eligibility assessment, data extraction, and quality evaluation were completed by 2 independent reviewers. A cutoff score of ≥65% of the maximal quality score was used for further inclusion in this review.
Six articles met all inclusion criteria. Two-point discrimination was shown to be predictive for upper limb dexterity, and somatosensory evoked potentials were shown to have predictive value in upper limb motor recovery. Proprioception was significantly correlated with perceived level of physical activity and social isolation and had some predictive value in functional movements of the upper limb. Finally, the combination of light touch and proprioception impairment was shown to be significantly related to upper limb motor recovery as well as handicap situations during activities of daily living.
Heterogeneity of the included studies warrants caution when interpreting results.
Large variation in results was found due to heterogeneity of the studies. However, somatosensory deficits were shown to have an important role in upper limb motor and functional performance after stroke.
感觉障碍与卒中后结局之间的关系尚不清楚。
本研究旨在系统回顾上肢感觉障碍与卒中后结局之间关系的现有文献。
系统检索了 PubMed、CINAHL、EMBASE、Cochrane 图书馆、PsycINFO 和 Web of Science 等电子数据库，检索时间截至 2013 年 7 月。
纳入研究对象为成人卒中患者（n≥10），采用可靠和有效的上肢感觉测量方法评估上肢感觉障碍与上肢功能、活动和参与测量之间的关系。排除标准包括涉及上肢和下肢结局综合评分的感觉测量方法和仅包括下肢结局的文章。
由 2 名独立评审员完成合格性评估、资料提取和质量评价。使用最高质量评分≥65%的标准进一步纳入本综述。
6 篇文章符合所有纳入标准。两点辨别觉与上肢灵巧性相关，体感诱发电位对上肢运动恢复有预测价值。本体感觉与感知的身体活动水平和社会隔离显著相关，对上肢功能运动有一定的预测价值。最后，轻触觉和本体感觉障碍的组合与上肢运动恢复以及日常生活活动中的残疾情况显著相关。
纳入研究的异质性限制了结果的解释。
由于研究的异质性，结果存在很大差异。然而，感觉障碍在上肢运动和功能表现方面与卒中后结局密切相关。
