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Creators/Authors contains: "Semrau, Jennifer_A"

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  1. Abstract Purpose of ReviewThe current review aims to address critical gaps in the field of stroke rehabilitation related to sensory impairment. Here, we examine the role and importance of sensation throughout recovery of neural injury, potential clinical and experimental approaches for improving sensory function, and mechanism-based theories that may facilitate the design of sensory-based approaches for the rehabilitation of somatosensation. Recent FindingsRecently, the field of neurorehabilitation has shifted to using more quantitative and sensitive measures to more accurately capture sensory function in stroke and other neurological populations. These approaches have laid the groundwork for understanding how sensory impairments impact overall function after stroke. However, there is less consensus on which interventions are effective for remediating sensory function, with approaches that vary from clinical re-training, robotics, and sensory stimulation interventions. SummaryCurrent evidence has found that sensory and motor systems are interdependent, but commonly have independent recovery trajectories after stroke. Therefore, it is imperative to assess somatosensory function in order to guide rehabilitation outcomes and trajectory. Overall, considerable work in the field still remains, as there is limited evidence for purported mechanisms of sensory recovery, promising early-stage work that focuses on sensory training, and a considerable evidence-practice gap related to clinical sensory rehabilitation. 
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  2. BackgroundUpper limb proprioceptive impairments are common after stroke and affect daily function. Recent work has shown that stroke survivors have difficulty using visual information to improve proprioception. It is unclear how eye movements are impacted to guide action of the arm after stroke. Here, we aimed to understand how upper limb proprioceptive impairments impact eye movements in individuals with stroke. MethodsControl (N = 20) and stroke participants (N = 20) performed a proprioceptive matching task with upper limb and eye movements. A KINARM exoskeleton with eye tracking was used to assess limb and eye kinematics. The upper limb was passively moved by the robot and participants matched the location with either an arm or eye movement. Accuracy was measured as the difference between passive robot movement location and active limb matching (Hand-End Point Error) or active eye movement matching (Eye-End Point Error). ResultsWe found that individuals with stroke had significantly larger Hand (2.1×) and Eye-End Point (1.5×) Errors compared to controls. Further, we found that proprioceptive errors of the hand and eye were highly correlated in stroke participants ( r = .67, P = .001), a relationship not observed for controls. ConclusionsEye movement accuracy declined as a function of proprioceptive impairment of the more-affected limb, which was used as a proprioceptive reference. The inability to use proprioceptive information of the arm to coordinate eye movements suggests that disordered proprioception impacts integration of sensory information across different modalities. These results have important implications for how vision is used to actively guide limb movement during rehabilitation. 
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