Health  Vol.4 No.12 , December 2012
Analysis of the sensory threshold between paretic and nonparetic sides for healthy rehabilitation in hemiplegic patients after stroke
ABSTRACT
The purpose of this study was to investigate the differences in the sensory threshold between the paretic and nonparetic sides of hemiplegic patients. 28 patients who were hemiplegic post-stroke (14 men and 14 women) participated in the electrical sensory and pain thresholds study; 22 patients who were hemiplegic post-stroke (13 men, 9 women) participated in a study measureing the sensory threshold with light touch. Electrical sensory and pain thresholds were measured in the forearm via transcutaneous electrical nerve stimulation. The light-touch threshold was measured in the forearm using monofilaments. The light-touch, electrical sensory, and pain thresholds for the paretic side were significantly higher than for the nonparetic side in our population, respectively. In both the nonparetic and paretic sides, the male group generally showed higher thresholds for pain and sensation than did the female group. These results suggest that the different evaluations of sensory thresholds performed in this study for healthy rehabilitation will be a valuable clinical tool in hemiplegic patients after stroke.

Cite this paper
Jeon, H. , Kim, J. , Hwang, B. , Kim, B. and Kim, J. (2012) Analysis of the sensory threshold between paretic and nonparetic sides for healthy rehabilitation in hemiplegic patients after stroke. Health, 4, 1241-1246. doi: 10.4236/health.2012.412183.
References
[1]   Anderson, E.K. (1971) Sensory impairments in hemiplegia. Archives of Physical Medicine and Rehabilitation, 52, 293-297.

[2]   Borstad, A., Schmalbrock, P., Choi, S. and Nichols-Larsen, D.S. (2012) Neural correlates supporting sensory discrimination after left hemisphere stroke. Brain Research, 1460, 78-87. doi:10.1016/j.brainres.2012.03.060

[3]   Nelles, M., et al. (2008) Diffusion tensor pyramidal tractography in patients with anterior choroidal artery infarcts. American Journal of Neuroradiology, 29, 488-493. doi:10.3174/ajnr.A0855

[4]   Schaechter, J.D., et al. (2006) Structural and functional plasticity in the somatosensory cortex of chronic stroke patients. Brain, 129, 2722-2733. doi:10.1093/brain/awl214

[5]   Wakana, S., et al. (2004) Fiber tract-based atlas of human white matter anatomy. Radiology, 230, 77-87. doi:10.1148/radiol.2301021640

[6]   Rose, L., et al. (1994) Tactile extinction and functional status after stroke: A preliminary investigation. Stroke, 25, 1973-1976. doi:10.1161/01.STR.25.10.1973

[7]   Kim, M.Y., et al. (2012) The effects of functional electrical stimulation on balance of stroke patients in the standing posture. Journal of Physical Therapy Science, 24, 77- 81. doi:10.1589/jpts.24.77

[8]   Kusoffsky, A., Wadell, I. and Nilsson, N.Y. (1982) The relationship between sensory impairment and motor recovery in patients with hemiplegia. Scandinavian Journal of Rehabilitation Medicine, 14, 27-32.

[9]   Aqlioti, S., et al. (1996) Thumb-pointing in humans after damage to somatic sensory cortex. Experimental Brain Research, 109, 92-100.

[10]   Yekutiel, M. and Guttman, E. (1993) A controlled trial of the retraining of the sensory function of the hand in stroke patients. Journal of Neurology, Neurosurgery & Psychia- try, 56, 241-244. doi:10.1136/jnnp.56.3.241

[11]   Sommerfeld, D.K. and von Arbin, M.H. (2004) The impact of somatosensory function on activity performance and length of hospital stay in geriatric patients with stroke. Clinical Rehabilitation, 18, 149-155. doi:10.1191/0269215504cr710oa

[12]   Tyson, S.F., et al. (2008) Sensory loss in hospital admitted people with stroke: Characteristics, associated factors, and relationship with function. Neurorehabilitation and Neural Repair, 22, 166-172. doi:10.1177/1545968307305523

[13]   Leeanne, M. and Thomas, A. (2001) Frequency of discriminative sensory loss in the hand after stroke in a rehabilitation setting. Journal of Rehabilitation Medicine, 43, 257-263.

[14]   Patel, A.T., et al. (2000) The relation between impairments and functional outcomes poststroke. Archives of Physical Medicine and Rehabilitation, 81, 1357-1363. doi:10.1053/apmr.2000.9397

[15]   Kim, J.S. and Choi-Kwon, S. (1996) Discriminative sensory dysfunction after unilateral stroke. Stroke, 27, 677- 682. doi:10.1161/01.STR.27.4.677

[16]   Gracely, R.H., et al. (1988) A multiple random staircase method of psychophysical pain assessment. Pain, 32, 55- 63. doi:10.1016/0304-3959(88)90023-1

[17]   Sang, C.H., Mitchell, B.M. and Gracely, R.H. (2003) Stability and reliability of detection thresholds for human A-beta and A-delta sensory afferents determined by cutaneous electrical stimulation. Journal of Pain and Symptom Management, 25, 64-73. doi:10.1016/S0885-3924(02)00541-9

[18]   Phyllis, M. (1997) Sensory function assessment: A pilot comparison study of touch pressure threshold with texture and tactile discrimination. Journal of Hand Therapy, 10, 24-28.

[19]   Lund, I., et al. (2005) Evaluation of variations in sensory and pain threshold assessments by electrocutaneous stimulation. Physiotherapy Theory and Practice, 21, 81-92. doi:10.1080/09593980590922307

[20]   Jeon, H.J., Kim, J.H., Kim, B. and Kim, J. (2012) Analysis of high-frequency transcutaneous electrical nerve stimulation-induced sensory threshold from the elderly people for healthy life. Toxicology and Environmental Health Sciences, 4, 167-172. doi:10.1007/s13530-012-0132-7

[21]   Leong, G.W., Lauschke, J., Rutowski, S.B. and Waite, P.M. (2010) Age, gender, and side differences of cutaneous electrical perceptual threshold testing in an ablebodied population. Journal of Spinal Cord Medicine, 33, 249-255.

[22]   Maffiuletti, N.A., et al. (2011) Effect of gender and obesity on electrical current thresholds. Muscle Nerve, 44, 202-207. doi:10.1002/mus.22050

[23]   Weinstein, S., Semmes, J., Ghent, L. and Teuber, H.L. (1958) Roughness discrimination after penetrating brain injury in man: Analysis according to locus of lesion. Journal of Comparative & Physiological Psychology, 51, 269-275. doi:10.1037/h0047187

[24]   Essing, J.P., Gersten, J.W. and Yarnell, P. (1980) Light touch thresholds in normal persons and cerebral vascular disease patient: Bilateral deficit after unilateral lesion. Stroke, 11, 528-533. doi:10.1161/01.STR.11.5.528

[25]   Corkin, S., Milner, B. and Rasmussen, T. (1970) Somato-sensory thresholds: Contrasting effects of postcentral gyrus and posterior parietallobe excisions. Archives of Neurology, 23, 41-58. doi:10.1001/archneur.1970.00480250045007

[26]   Carey, L.M. (1995) Somatosensory loss after stroke. Critical Reviews in Physical and Rehabilitation Medicine, 7, 51-91.

[27]   Fillingim, R.B. (2000) Sex, gender, and pain: Women and men really are different. Current Review of Pain, 4, 24-30. doi:10.1007/s11916-000-0006-6

[28]   Riley, J.L. 3rd, et al. (1998) Sex differences in the perception of noxious experimental stimuli: A meta-analysis. Pain, 74, 181-187. doi:10.1016/S0304-3959(97)00199-1

[29]   Lautenbacher, S. and Rollman, G.B. (1993) Sex differences in responsiveness to painful and non-painful stimuli are dependent upon the stimulation method. Pain, 53, 255-264. doi:10.1016/0304-3959(93)90221-A

[30]   Caissie, R., et al. (2007) Quantitative method to evaluate the functionality of the trigeminal nerve. Journal of Oral and Maxillofacial Surgery, 65, 2254-2259. doi:10.1016/j.joms.2006.09.010

[31]   G?ransson, L.G., Mellgren, S.I., Lindal, S. and Omdal, R. (2004) The effect of age and gender on epidermal nerve fiber density. Neurology, 62, 774-777. doi:10.1212/01.WNL.0000113732.41127.8F

[32]   Leitgeb, N., Schroettner, J. and Cech, R. (2005) Electric current perception of the general population including children and the elderly. Journal of Medical Engineering & Technology, 29, 215-218. doi:10.1080/03091900412331291705

[33]   Irnich, W. and Batz, L. (1989) The perception threshold for 50 Hz alternating voltage and current. Biomedical Technician (Berlin), 34, 207-209. doi:10.1515/bmte.1989.34.9.207

[34]   Bakkers, M., et al. (2009) Intraepidermal nerve fiber density and its application in sarcoidosis. Neurology, 73, 1142-1148. doi:10.1212/WNL.0b013e3181bacf05

[35]   Mowlavi, A., et al. (2005) Increased cutaneous nerve fibers in female specimens. Plastic and Reconstructive Surgery, 116, 1407-1410. doi:10.1097/01.prs.0000182339.83156.06

[36]   Roglio, I., et al. (2008) Neuroactive steroids and peripheral neuropathy. Brain Research Reviews, 57, 460-469. doi:10.1016/j.brainresrev.2007.04.010

[37]   Campbell, J.K., et al. (1978) Computed tomography and radionuclide imaging in the evaluation of ischemic stroke. Radiology, 126, 695-702.

[38]   Yarnell, P., Monroe, P. and Sobel, L. (1976) Aphasia outcome in stroke: A clinical neuroradiological correlation. Stroke, 7, 516-522. doi:10.1161/01.STR.7.5.516

[39]   Baumann, K.I., Hamann, W. and Leung, M.S. (1986) Mechanical properties of skin and responsiveness of slowly adapting type I mechanoreceptors in rats at different ages. The Journal of Physiology, 371, 329-337.

[40]   Ras, V.R. and Nava, P.B. (1986) Age-related changes of neurites in Meissner corpuscles of diabetic mice. Experimental Neurology, 91, 488-501. doi:10.1016/0014-4886(86)90047-6

[41]   Cauna, N. and Ross, L.L. (1960) The fine structure of Meissner’s touch corpuscles of human fingers. Journal of Biophysical and Biochemical Cytology, 8, 467-482. doi:10.1083/jcb.8.2.467

[42]   Bolton, C.F., Winkelmann, R.K. and Dyck, P.J. (1964) A quantitative study of Meissner’s corpuscles in man. Transactions of the American Neurological Association, 89, 190-192.

[43]   Bruce, M.F. (1980) The relation of tactile thresholds to histology in the fingers of elderly people. Journal of Neurology, Neurosurgery & Psychiatry, 43, 730-734. doi:10.1136/jnnp.43.8.730

 
 
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