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Carey LM. 2023 Sylvia Docker lecture: Ignite your passion, and connect, to make a difference. Aust Occup Ther J 2024; 71:4-17. [PMID: 38234045 DOI: 10.1111/1440-1630.12923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 11/28/2023] [Indexed: 01/19/2024]
Abstract
Together, we grow our profession of occupational therapy as we engage in understanding and addressing the issues that challenge the people we work with. In this Sylvia Docker Lecture, I will share the collective journeys of myself and other occupational therapists and health professionals who have undertaken (or are currently undertaking) their PhDs and are actively involved in research, to address these challenges. Together, we will explore three themes: understanding the WHY that ignites one's passion; living the journey-the EXPERIENCE; and making a difference-the IMPACT. Stories will be told through the lived experience of those engaged in research as currently enrolled PhD students, emerging researchers, and experienced researchers. These stories will capture the lived experience across individuals, and at different times in the research journey. Stories are summarised and captured using natural language processing. Topics are identified, concept maps visualised, and outputs interpreted in context of related theoretical models. Key topics identified include: the clinical and personal motivators that have ignited the passion in individuals; the value of connecting with others and growing networks; and how one's research has made a difference. The impact of discoveries and outcomes are highlighted, together with the importance of people and networks. Analysis of connections and synthesis over time revealed frequent and strong connections across themes, concepts and topics; with synthesising concepts of passion, networks, knowledge translation, opportunities, supervision and communication emerging and being shaped over time. These collective journeys provide inspiration and pathways to creative careers that have future potential in the growth of the profession of occupational therapy. It is recommended that each occupational therapist take the time to reflect on the 'why' that ignites your passion, your journey and how you can make a difference!
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Affiliation(s)
- Leeanne M Carey
- Department of Community and Clinical Health, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
- The Florey Institute of Neuroscience and Mental Health, Melbourne Brain Centre, Heidelberg, Victoria, Australia
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Hoh JE, Borich MR, Kesar TM, Reisman DS, Semrau JA. Limitations in utilization and prioritization of standardized somatosensory assessments after stroke: A cross-sectional survey of neurorehabilitation clinicians. Top Stroke Rehabil 2024; 31:29-43. [PMID: 37061928 DOI: 10.1080/10749357.2023.2200304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 04/02/2023] [Indexed: 04/17/2023]
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.
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Affiliation(s)
- Joanna Eskander Hoh
- Biomechanics and Movement Science Program, University of Delaware, Newark, USA
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, USA
| | - Michael R Borich
- Center for Physical Therapy and Movement Science, Emory University, Atlanta, GA, USA
- Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Trisha M Kesar
- Center for Physical Therapy and Movement Science, Emory University, Atlanta, GA, USA
- Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Darcy S Reisman
- Biomechanics and Movement Science Program, University of Delaware, Newark, USA
- Department of Physical Therapy, University of Delaware, Newark, USA
| | - Jennifer A Semrau
- Biomechanics and Movement Science Program, University of Delaware, Newark, USA
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, USA
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Saenen L, Verheyden G, Orban de Xivry JJ. The differential effect of age on upper limb sensory processing, proprioception, and motor function. J Neurophysiol 2023; 130:1183-1193. [PMID: 37703491 DOI: 10.1152/jn.00364.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/07/2023] [Accepted: 09/13/2023] [Indexed: 09/15/2023] Open
Abstract
Sensory processing consists in the integration and interpretation of somatosensory information. It builds upon proprioception but is a distinct function requiring complex processing by the brain over time. Currently little is known about the effect of aging on sensory processing ability or the influence of other covariates such as motor function, proprioception, or cognition. In this study, we measured upper limb passive and active sensory processing, motor function, proprioception, and cognition in 40 healthy younger adults and 54 older adults. We analyzed age differences across all measures and evaluated the influence of covariates on sensory processing through regression. Our results showed larger effect sizes for age differences in sensory processing (r = 0.38) compared with motor function (r = 0.18-0.22) and proprioception (r = 0.10-0.27) but smaller than for cognition (r = 0.56-0.63). Aside from age, we found no evidence that sensory processing performance was related to motor function or proprioception, but active sensory processing was related to cognition (β = 0.30-0.42). In conclusion, sensory processing showed an age-related decline, whereas some proprioceptive and motor abilities were preserved across age.NEW & NOTEWORTHY Sensory processing consists in the integration and interpretation of sensory information by the brain over time and can be affected by lesion while proprioception remains intact. We investigated how sensory processing can be used to reproduce and identify shapes. We showed that the effect of age on sensory processing is more pronounced than its effect on proprioception or motor function. Age and cognition are related to sensory processing, not proprioception or motor function.
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Affiliation(s)
- Leen Saenen
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Geert Verheyden
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Jean-Jacques Orban de Xivry
- Department of Movement Sciences, KU Leuven, Leuven, Belgium
- Leuven Brain Institute, KU Leuven, Leuven, Belgium
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Ujitoko Y, Ban Y. Toward Designing Haptic Displays for Desired Touch Targets: A Study of User Expectation for Haptic Properties via Crowdsourcing. IEEE TRANSACTIONS ON HAPTICS 2023; 16:726-735. [PMID: 37651490 DOI: 10.1109/toh.2023.3310662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
Things that people desire to touch in daily life are known to be limited to a number of specific targets (e.g., cats). The utilization of haptic displays to provide the experience of touching such desired targets is expected to enhance people's quality of life. However, it is currently unclear which haptic properties (e.g., hardness and weight) of desired targets should be rendered with haptic displays, and how they should be rendered. To address these issues, we conducted an experiment with 600 Japanese participants via crowdsourcing. Among the 600 participants, we identified potential users of haptic displays and analyzed their responses for each target. For each desired target, we identified the haptic properties in relation to which a "need for consistency" was felt by potential users between their expectations and actual impressions during touching. We also identified the haptic properties in relation to which a "biased impression" was held by potential users for each target. For example, potential users responded that cats were soft and that the actual impression of softness during touching needed to be consistent with their impression. Our results provide insights into the design of haptic displays for realizing desired touch experiences.
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Senadheera I, Larssen BC, Mak-Yuen YYK, Steinfort S, Carey LM, Alahakoon D. Profiling Somatosensory Impairment after Stroke: Characterizing Common "Fingerprints" of Impairment Using Unsupervised Machine Learning-Based Cluster Analysis of Quantitative Measures of the Upper Limb. Brain Sci 2023; 13:1253. [PMID: 37759854 PMCID: PMC10526214 DOI: 10.3390/brainsci13091253] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 08/14/2023] [Accepted: 08/21/2023] [Indexed: 09/29/2023] Open
Abstract
Altered somatosensory function is common among stroke survivors, yet is often poorly characterized. Methods of profiling somatosensation that illustrate the variability in impairment within and across different modalities remain limited. We aimed to characterize post-stroke somatosensation profiles ("fingerprints") of the upper limb using an unsupervised machine learning cluster analysis to capture hidden relationships between measures of touch, proprioception, and haptic object recognition. Raw data were pooled from six studies where multiple quantitative measures of upper limb somatosensation were collected from stroke survivors (n = 207) using the Tactile Discrimination Test (TDT), Wrist Position Sense Test (WPST) and functional Tactile Object Recognition Test (fTORT) on the contralesional and ipsilesional upper limbs. The Growing Self Organizing Map (GSOM) unsupervised machine learning algorithm was used to generate a topology-preserving two-dimensional mapping of the pooled data and then separate it into clusters. Signature profiles of somatosensory impairment across two modalities (TDT and WPST; n = 203) and three modalities (TDT, WPST, and fTORT; n = 141) were characterized for both hands. Distinct impairment subgroups were identified. The influence of background and clinical variables was also modelled. The study provided evidence of the utility of unsupervised cluster analysis that can profile stroke survivor signatures of somatosensory impairment, which may inform improved diagnosis and characterization of impairment patterns.
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Affiliation(s)
- Isuru Senadheera
- Centre for Data Analytics and Cognition, La Trobe Business School, La Trobe University, Melbourne, VIC 3086, Australia;
- Occupational Therapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC 3086, Australia; (B.C.L.); (Y.Y.K.M.-Y.); (S.S.); (L.M.C.)
| | - Beverley C. Larssen
- Occupational Therapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC 3086, Australia; (B.C.L.); (Y.Y.K.M.-Y.); (S.S.); (L.M.C.)
- Department of Physical Therapy, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Yvonne Y. K. Mak-Yuen
- Occupational Therapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC 3086, Australia; (B.C.L.); (Y.Y.K.M.-Y.); (S.S.); (L.M.C.)
- Neurorehabilitation and Recovery, Florey Institute of Neuroscience and Mental Health, Melbourne, VIC 3086, Australia
- Department of Occupational Therapy, St. Vincent’s Hospital Melbourne, Fitzroy, VIC 3065, Australia
| | - Sarah Steinfort
- Occupational Therapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC 3086, Australia; (B.C.L.); (Y.Y.K.M.-Y.); (S.S.); (L.M.C.)
- Neurorehabilitation and Recovery, Florey Institute of Neuroscience and Mental Health, Melbourne, VIC 3086, Australia
| | - Leeanne M. Carey
- Occupational Therapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC 3086, Australia; (B.C.L.); (Y.Y.K.M.-Y.); (S.S.); (L.M.C.)
- Neurorehabilitation and Recovery, Florey Institute of Neuroscience and Mental Health, Melbourne, VIC 3086, Australia
| | - Damminda Alahakoon
- Centre for Data Analytics and Cognition, La Trobe Business School, La Trobe University, Melbourne, VIC 3086, Australia;
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Matyas TA, Mak-Yuen YYK, Boelsen-Robinson TP, Carey LM. Calibration of Impairment Severity to Enable Comparison across Somatosensory Domains. Brain Sci 2023; 13:brainsci13040654. [PMID: 37190619 DOI: 10.3390/brainsci13040654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 04/06/2023] [Accepted: 04/08/2023] [Indexed: 05/17/2023] Open
Abstract
Comparison across somatosensory domains, important for clinical and scientific goals, requires prior calibration of impairment severity. Provided test score distributions are comparable across domains, valid comparisons of impairment can be made by reference to score locations in the corresponding distributions (percentile rank or standardized scores). However, this is often not the case. Test score distributions for tactile texture discrimination (n = 174), wrist joint proprioception (n = 112), and haptic object identification (n = 98) obtained from pooled samples of stroke survivors in rehabilitation settings were investigated. The distributions showed substantially different forms, undermining comparative calibration via percentile rank or standardized scores. An alternative approach is to establish comparable locations in the psychophysical score ranges spanning performance from just noticeably impaired to maximally impaired. Several simulation studies and a theoretical analysis were conducted to establish the score distributions expected from completely insensate responders for each domain. Estimates of extreme impairment values suggested by theory, simulation and observed samples were consistent. Using these estimates and previously discovered values for impairment thresholds in each test domain, comparable ranges of impairment from just noticeable to extreme impairment were found. These ranges enable the normalization of the three test scales for comparison in clinical and research settings.
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Affiliation(s)
- Thomas A Matyas
- Occupational Therapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC 3086, Australia
- Neurorehabilitation and Recovery, Florey Institute of Neuroscience and Mental Health, Heidelberg, Melbourne, VIC 3084, Australia
| | - Yvonne Y K Mak-Yuen
- Occupational Therapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC 3086, Australia
- Neurorehabilitation and Recovery, Florey Institute of Neuroscience and Mental Health, Heidelberg, Melbourne, VIC 3084, Australia
- Department of Occupational Therapy, St Vincent's Hospital Melbourne, Fitzroy, Melbourne, VIC 3065, Australia
| | - Tristan P Boelsen-Robinson
- Occupational Therapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC 3086, Australia
| | - Leeanne M Carey
- Occupational Therapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC 3086, Australia
- Neurorehabilitation and Recovery, Florey Institute of Neuroscience and Mental Health, Heidelberg, Melbourne, VIC 3084, Australia
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Mak-Yuen YYK, Matyas TA, Carey LM. Characterizing Touch Discrimination Impairment from Pooled Stroke Samples Using the Tactile Discrimination Test: Updated Criteria for Interpretation and Brief Test Version for Use in Clinical Practice Settings. Brain Sci 2023; 13:brainsci13040533. [PMID: 37190498 DOI: 10.3390/brainsci13040533] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/19/2023] [Accepted: 03/20/2023] [Indexed: 05/17/2023] Open
Abstract
Somatosensory loss post-stroke is common, with touch sensation characteristically impaired. Yet, quantitative, standardized measures of touch discrimination available for clinical use are currently limited. We aimed to characterize touch impairment and re-establish the criterion of abnormality of the Tactile Discrimination Test (TDT) using pooled data and to determine the sensitivity and specificity of briefer test versions. Baseline data from stroke survivors (n = 207) and older neurologically healthy controls (n = 100) assessed on the TDT was extracted. Scores were re-analyzed to determine an updated criterion of impairment and the ability of brief test versions to detect impairment. Updated scoring using an area score was used to calculate the TDT percent maximum area (PMA) score. Touch impairment was common for the contralesional hand (83%) but also present in the ipsilesional hand (42%). The criterion of abnormality was established as 73.1 PMA across older adults and genders. High sensitivity and specificity were found for briefer versions of the TDT (25 vs. 50 trials; 12 or 15 vs. 25 trials), with sensitivity ranging between 91.8 and 96.4% and specificity between 72.5 and 95.0%. Conclusion: Updated criterion of abnormality and the high sensitivity and specificity of brief test versions support the use of the TDT in clinical practice settings.
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Affiliation(s)
- Yvonne Y K Mak-Yuen
- Occupational Therapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne 3086, Australia
- Neurorehabilitation and Recovery, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne 3084, Australia
- Department of Occupational Therapy, St Vincent's Hospital Melbourne, Melbourne 3065, Australia
| | - Thomas A Matyas
- Occupational Therapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne 3086, Australia
- Neurorehabilitation and Recovery, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne 3084, Australia
| | - Leeanne M Carey
- Occupational Therapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne 3086, Australia
- Neurorehabilitation and Recovery, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne 3084, Australia
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Gopaul U, Laver D, Carey L, Matyas T, van Vliet P, Callister R. Measures of Maximal Tactile Pressures during a Sustained Grasp Task Using a TactArray Device Have Satisfactory Reliability and Concurrent Validity in People with Stroke. SENSORS (BASEL, SWITZERLAND) 2023; 23:3291. [PMID: 36992002 PMCID: PMC10059963 DOI: 10.3390/s23063291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/13/2023] [Accepted: 03/17/2023] [Indexed: 06/19/2023]
Abstract
Sensor-based devices can record pressure or force over time during grasping and therefore offer a more comprehensive approach to quantifying grip strength during sustained contractions. The objectives of this study were to investigate the reliability and concurrent validity of measures of maximal tactile pressures and forces during a sustained grasp task using a TactArray device in people with stroke. Participants with stroke (n = 11) performed three trials of sustained maximal grasp over 8 s. Both hands were tested in within- and between-day sessions, with and without vision. Measures of maximal tactile pressures and forces were measured for the complete (8 s) grasp duration and plateau phase (5 s). Tactile measures are reported using the highest value among three trials, the mean of two trials, and the mean of three trials. Reliability was determined using changes in mean, coefficients of variation, and intraclass correlation coefficients (ICCs). Pearson correlation coefficients were used to evaluate concurrent validity. This study found that measures of reliability assessed by changes in means were good, coefficients of variation were good to acceptable, and ICCs were very good for maximal tactile pressures using the average pressure of the mean of three trials over 8 s in the affected hand with and without vision for within-day sessions and without vision for between-day sessions. In the less affected hand, changes in mean were very good, coefficients of variations were acceptable, and ICCs were good to very good for maximal tactile pressures using the average pressure of the mean of three trials over 8 s and 5 s, respectively, in between-day sessions with and without vision. Maximal tactile pressures had moderate correlations with grip strength. The TactArray device demonstrates satisfactory reliability and concurrent validity for measures of maximal tactile pressures in people with stroke.
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Affiliation(s)
- Urvashy Gopaul
- KITE Research—Toronto Rehabilitation Institute, University Health Network, Toronto, ON M5G 2A2, Canada
| | - Derek Laver
- Human Physiology, School of Biomedical Sciences & Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Leeanne Carey
- Occupational Therapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne Campus, Melbourne, VIC 3086, Australia
- Neurorehabilitation and Recovery Group, the Florey Institute of Neuroscience and Mental Health, Austin Campus, Heidelberg, VIC 3084, Australia
| | - Thomas Matyas
- Occupational Therapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne Campus, Melbourne, VIC 3086, Australia
| | - Paulette van Vliet
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, NSW 2308, Australia
| | - Robin Callister
- Human Physiology, School of Biomedical Sciences & Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia
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Haslam BS, Butler DS, Kim AS, Carey LM. Somatosensory Impairment and Chronic Pain Following Stroke: An Observational Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:906. [PMID: 36673661 PMCID: PMC9859194 DOI: 10.3390/ijerph20020906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 12/27/2022] [Accepted: 12/31/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Chronic pain and somatosensory impairment are common following a stroke. It is possible that an interaction exists between pain and somatosensory impairment and that a change in one may influence the other. We therefore investigated the presence of chronic pain and self-reported altered somatosensory ability in individuals with stroke, aiming to determine if chronic pain is more common in stroke survivors with somatosensory impairment than in those without. METHODS Stroke survivors were invited to complete an online survey that included demographics, details of the stroke, presence of chronic pain, and any perceived changes in body sensations post-stroke. RESULTS Survivors of stroke (n = 489) completed the survey with 308 indicating that they experienced chronic pain and 368 reporting perceived changes in somatosensory function. Individuals with strokes who reported altered somatosensory ability were more likely to experience chronic pain than those who did not (OR = 1.697; 95% CI 1.585, 2.446). Further, this difference was observed for all categories of sensory function that were surveyed (detection of light touch, body position, discrimination of surfaces and temperature, and haptic object recognition). CONCLUSIONS The results point to a new characteristic of chronic pain in strokes, regardless of nature or region of the pain experienced, and raises the potential of somatosensory impairment being a rehabilitation target to improve pain-related outcomes for stroke survivors.
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Affiliation(s)
- Brendon S. Haslam
- Occupational Therapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne 3086, Australia
- Neurorehabilitation and Recovery, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne 3010, Australia
| | - David S. Butler
- IMPACT in Health, University of South Australia, Kaurna Country, Adelaide 5001, Australia
- Neuro-Orthopaedic Institute, Adelaide 5000, Australia
| | - Anthony S. Kim
- Weil Institute of Neurosciences, Department of Neurology, University of California, San Francisco, CA 94143, USA
| | - Leeanne M. Carey
- Occupational Therapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne 3086, Australia
- Neurorehabilitation and Recovery, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne 3010, Australia
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Development and Validation of a Novel Robot-Based Assessment of Upper Limb Sensory Processing in Chronic Stroke. Brain Sci 2022; 12:brainsci12081005. [PMID: 36009069 PMCID: PMC9406163 DOI: 10.3390/brainsci12081005] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 07/25/2022] [Accepted: 07/27/2022] [Indexed: 02/04/2023] Open
Abstract
Upper limb sensory processing deficits are common in the chronic phase after stroke and are associated with decreased functional performance. Yet, current clinical assessments show suboptimal psychometric properties. Our aim was to develop and validate a novel robot-based assessment of sensory processing. We assessed 60 healthy participants and 20 participants with chronic stroke using existing clinical and robot-based assessments of sensorimotor function. In addition, sensory processing was evaluated with a new evaluation protocol, using a bimanual planar robot, through passive or active exploration, reproduction and identification of 15 geometrical shapes. The discriminative validity of this novel assessment was evaluated by comparing the performance between healthy participants and participants with stroke, and the convergent validity was evaluated by calculating the correlation coefficients with existing assessments for people with stroke. The results showed that participants with stroke showed a significantly worse sensory processing ability than healthy participants (passive condition: p = 0.028, Hedges’ g = 0.58; active condition: p = 0.012, Hedges’ g = 0.73), as shown by the less accurate reproduction and identification of shapes. The novel assessment showed moderate to high correlations with the tactile discrimination test: a sensitive clinical assessment of sensory processing (r = 0.52–0.71). We conclude that the novel robot-based sensory processing assessment shows good discriminant and convergent validity for use in participants with chronic stroke.
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Abstract
Background—In aircraft engine maintenance, the majority of parts, including engine blades, are inspected visually for any damage to ensure a safe operation. While this process is called visual inspection, there are other human senses encompassed in this process such as tactile perception. Thus, there is a need to better understand the effect of the tactile component on visual inspection performance and whether this effect is consistent for different defect types and expertise groups. Method—This study comprised three experiments, each designed to test different levels of visual and tactile abilities. In each experiment, six industry practitioners of three expertise groups inspected the same sample of N = 26 blades. A two-week interval was allowed between the experiments. Inspection performance was measured in terms of inspection accuracy, inspection time, and defect classification accuracy. Results—The results showed that unrestrained vision and the addition of tactile perception led to higher inspection accuracies of 76.9% and 84.0%, respectively, compared to screen-based inspection with 70.5% accuracy. An improvement was also noted in classification accuracy, as 39.1%, 67.5%, and 79.4% of defects were correctly classified in screen-based, full vision and visual–tactile inspection, respectively. The shortest inspection time was measured for screen-based inspection (18.134 s) followed by visual–tactile (22.140 s) and full vision (25.064 s). Dents benefited the most from the tactile sense, while the false positive rate remained unchanged across all experiments. Nicks and dents were the most difficult to detect and classify and were often confused by operators. Conclusions—Visual inspection in combination with tactile perception led to better performance in inspecting engine blades than visual inspection alone. This has implications for industrial training programmes for fault detection.
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