A roadmap for somatosensory rehabilitation and research after stroke: Consensus-based core recommendations from the fourth Stroke Recovery and Rehabilitation Roundtable.

BACKGROUND

Post-stroke somatosensory impairments, including deficits in touch and proprioception, are common. They alter body perception and can be a hidden cause of motor disability. They are often underrecognized in clinical care, highlighting the need for consensus recommendations.

AIM: The Somatosensory Roundtable aimed to provide:A. A framework for understanding somatosensationB. Expert-informed consensus recommendations for somatosensory interventions that have potential for use in clinical practice with stroke survivorsC. Consensus recommendations for research priorities to advance clinical practice and accelerate targeted research in somatosensory recovery and rehabilitation post-stroke.

METHODS

An international group of clinical, research, pre-clinical and lived experience experts was established. A systematic search of the literature and opinions of Somatosensory Roundtable members, clinicians, and people with lived experience of stroke, were used to generate lists of somatosensory interventions and research priorities for ranking in separate consensus ranking surveys. A structured consensus and voting process was adopted, with consensus ranks established through independent, individual ranking by Somatosensory Roundtable members.

RESULTS

An agreed definition and framework for understanding somatosensation was developed. Somatosensory discrimination training was ranked highest for perceived effectiveness and feasibility, with plantar tactile/proprioceptive stimulation and hands-on mechanoreceptor stimulation ranked second and third. Research priority consensus ranks were: 1) effectiveness of somatosensory interventions (highest); 2) standardized measures of impairment and impact; 3) somatosensation and recovery; 4) lived experience of sensory impairment and rehabilitation; 5) individualized therapy development; 6) knowledge translation; and 7) biomarkers.

CONCLUSIONS

A framework for understanding somatosensation, and consensus-based recommendations for somatosensory interventions and for research priorities are provided to advance the science and practice of evidence-based rehabilitation of somatosensation after stroke.