Impact of somatosensory deficits on functional independence after first inpatient rehabilitation program post-stroke

Abstract

It is estimated that somatosensory deficits (SSD) are present in more than half of ischemic strokes. SSD can influence motor outcomes and thereby impair participation in activities of daily living (ADL). Rather few studies have investigated SSD after stroke. Previous studies showed a negative correlation between SSD following stroke, the functional prognosis of rehabilitation. The aim of this study is to illustrate the influence of SSD in functional outcomes as measured by the functional independence measure (FIM). Prospective observational study, with retrospective analysis of admission and discharge data, after a 1st inpatient rehabilitation program. Four groups were created: A - no SSD, B - only superficial SSD, C - only deep SSD, and D - both types of SSD. Functionality was measured by the FIM, subdivided in ADL, motor outcomes, cognitive outcomes and total outcome. The results were analyzed with Anova. From a total of 119 patients who were discharged in 2014, complete data on SSD were available for 79, of which 57% were women. Mean age was 60.84 years. In 68% of cases the stroke was ischaemic. On average, patient stay was 65.82 days (SD 13.66). At admission, 22 patients had no SSD, 9 patients had changes only in superficial sensitivity, 3 had only deep sensitivity and 45 had both types of SSD. There are significant differences between having no SSD and having both types of SSD, regarding ADL, motor scores and total FIM scores, at admission. At discharge, the differences were statistically significant for: ADL, motor scores, cognitive and total FIM scores, as well as for the change of ADL scores and total FIM scores. SSD had an impact in the functional outcomes, especially when both SSD were impaired. In agreement with previously published data, SSD after stroke have a negative effect on motor and functional performance.