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Meta-Analysis
. 2019 Jun;33(6):964-979.
doi: 10.1177/0269215519836461. Epub 2019 Mar 22.

Sensory retraining of the leg after stroke: systematic review and meta-analysis

Fenny Sf Chia  1   2 , Suzanne Kuys  1 , Nancy Low Choy  1   3
Affiliations
Meta-Analysis

Sensory retraining of the leg after stroke: systematic review and meta-analysis

Fenny Sf Chia et al. Clin Rehabil. 2019 Jun.

Abstract

Objective: This systematic review aimed to investigate the effects of interventions intended for retraining leg somatosensory function on somatosensory impairment, and secondary outcomes of balance and gait, after stroke.

Data sources: Databases searched from inception to 16 January 2019 included Cochrane Library, PubMed, MEDLINE, CINAHL, EMBASE, PEDro, PsycINFO, and Scopus. Reference lists of relevant publications were also manually searched.

Review methods: All types of quantitative studies incorporating interventions that intended to improve somatosensory function in the leg post stroke were retrieved. The Quality Assessment Tool for Quantitative Studies was used for quality appraisal. Standardised mean differences were calculated and meta-analyses were performed using preconstructed Microsoft Excel spreadsheets.

Results: The search yielded 16 studies, comprising 430 participants, using a diverse range of interventions. In total, 10 of the included studies were rated weak in quality, 6 were rated moderate, and none was rated strong. Study quality was predominantly affected by high risk of selection bias, lack of blinding, and the use of somatosensory measures that have not been psychometrically evaluated. A significant heterogeneous positive summary effect size (SES) was found for somatosensory outcomes (SES: 0.52; 95% confidence interval (CI): 0.04 to 1.01; I2 = 74.48%), which included joint position sense, light touch, and two-point discrimination. There was also a significant heterogeneous positive SES for Berg Balance Scale scores (SES: 0.62; 95% CI: 0.10 to 1.14; I2 = 59.05%). Gait SES, mainly of gait velocity, was not significant.

Conclusion: This review suggests that interventions used for retraining leg somatosensory impairment after stroke significantly improved somatosensory function and balance but not gait.

Keywords: Systematic review; lower limb; retraining; somatosensory; stroke.

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Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
PRISMA flow diagram.
Figure 2.
Figure 2.
Hedges’ g (95% CI) and summary of effect size (95% CI) on somatosensory outcomes. SES: summary effect size; CI: confidence interval; RPM: repeated passive movement; RAM: repeated active movement; PAR: passive angle repositioning; AAR: active angle repositioning. The squares on the forest plot are of the same size, instead of proportional to study weight, as the forest plot was generated on Microsoft Excel.
Figure 3.
Figure 3.
Hedges’ g (95% CI) and summary effect size (95% CI) on Berg Balance Scale scores. SES: summary effect size; CI: confidence interval. The squares on the forest plot are of the same size, instead of proportional to study weight, as the forest plot was generated on Microsoft Excel.
Figure 4.
Figure 4.
Hedges’ g (95% CI) and summary effect size (95% CI) on gait velocity. SES: summary effect size; CI: confidence interval. The squares on the forest plot are of the same size, instead of proportional to study weight, as the forest plot was generated on Microsoft Excel.
See this image and copyright information in PMC

References

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MeSH terms