Ahmad Adamu Adamu, Suriyaamarit Duangporn, Siriphorn Akkradate
Human Movement Performance Enhancement Research Unit, Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand.
Department of Physiotherapy, Aminu Kano Teaching Hospital, Kano, Nigeria.
PLoS One. 2024 Dec 6;19(12):e0315097. doi: 10.1371/journal.pone.0315097. eCollection 2024.
Stroke frequently leads to motor impairments, with almost half of the affected individuals experiencing diminished sensation, impacting their overall quality of life and autonomy. Rehabilitation efforts, however, often overlook somatosensory functions of the lower limbs. While plantar sensory stimulation activates receptors in the foot sole, its precise impact on the motor functions and gait of individuals with stroke is yet to be ascertained.
This systematic review and meta-analysis aimed to examine the effects of sensory interventions on gait and lower limb motor function in individuals with stroke.
We searched eight databases from inception to December 2023 for randomized controlled trials that investigated sensory interventions targeting gait or lower limb motor function in stroke patients. The primary outcomes included changes in gait and motor function, reported as standardized mean differences (SMD) and assessed heterogeneity (I2).
A total of [number] studies were included, covering different sensory modalities such as textured insoles, plantar vibration, and cognitive sensorimotor exercises. The interventions showed varying effectiveness, with plantar vibration therapy exhibiting a large effect size (SMD = 2.03 [1.13, 2.94]) for improving lower limb motor function, while textured insoles showed moderate effectiveness (SMD = 0.58 [0.24, 0.92]) with no heterogeneity (I2 = 0%). For gait, significant enhancement was seen with plantar vibration (SMD = 3.17 [2.05, 4.29]) and cognitive sensorimotor training (SMD = 2.85 [1.69, 4.02]). However, overall heterogeneity was moderate to high (I2 = 65% for motor function, 85% for gait), indicating variability across different studies and intervention types.
The findings of this review and meta-analysis suggest that plantar somatosensory stimulation has the potential to improve lower limb motor function and gait in people with stroke. However, to firmly establish its efficacy as a rehabilitative tool, larger-scale and high-quality studies are requisite.
中风常导致运动功能障碍，近半数患者存在感觉减退，影响其整体生活质量和自主性。然而，康复治疗往往忽视下肢的体感功能。虽然足底感觉刺激可激活足底的感受器，但其对中风患者运动功能和步态的精确影响尚待确定。
本系统评价和荟萃分析旨在研究感觉干预对中风患者步态和下肢运动功能的影响。
我们检索了从数据库建立至2023年12月的八个数据库，以查找针对中风患者步态或下肢运动功能的感觉干预的随机对照试验。主要结局包括步态和运动功能的变化，以标准化均数差值（SMD）报告，并评估异质性（I2）。
共纳入[数字]项研究，涵盖不同的感觉方式，如纹理鞋垫、足底振动和认知感觉运动训练。这些干预措施显示出不同的效果，足底振动疗法对改善下肢运动功能显示出较大的效应量（SMD = 2.03 [1.13, 2.94]），而纹理鞋垫显示出中等效果（SMD = 0.58 [0.24, 0.92]），且无异质性（I2 = 0%）。对于步态，足底振动（SMD = 3.17 [2.05, 4.29]）和认知感觉运动训练（SMD = 2.85 [1.69, 4.02]）均有显著改善。然而，总体异质性为中度至高度（运动功能方面I2 = 65%，步态方面I2 = 85%），表明不同研究和干预类型之间存在差异。
本综述和荟萃分析的结果表明，足底体感刺激有可能改善中风患者的下肢运动功能和步态。然而，要将其作为一种康复工具的确切疗效，还需要大规模的高质量研究。
