Upper-limb sensory impairments after stroke: Self-reported experiences of daily life and rehabilitation

Abstract

OBJECTIVE: To describe stroke survivors' experiences of sensory impairment in the upper limb, the influence of such impairment on daily life, coping strategies used, and sensory training for the affected hand. DESIGN: A qualitative study with a content analysis approach. SUBJECTS: Fifteen post-stroke patients interviewed individually. RESULTS: Five categories emerged from the data: "Changed and varied perception of the sensation"; "Affected movement control"; "Problems using the hand in daily life"; "Various strategies to cope with upper limb disability"; and "Lack of sensory training". Numbness and tingling, changes in temperature sensitivity, and increased sensitivity to touch and pain were reported. Many subjects had difficulty adjusting their grip force and performing movements with precision. It was problematic and mentally fatiguing managing personal care and carrying out household and leisure activities. Practical adaptations, compensation with vision, increased concentration, and use of the less affected hand were strategies used to overcome difficulties. Despite their problems very few subjects had received any specific sensory training for the hand. CONCLUSION: Stroke survivors perceive that sensory impairment of the upper limb has a highly negative impact on daily life, but specific rehabilitation for the upper limb is lacking. These findings imply that the clinical management of upper limb sensory impairment after stroke requires more attention.