Somatosensory recovery: a longitudinal study of the first 6 months after unilateral stroke.

PURPOSE: The aim of this study was to characterize the recovery pattern of stroke patients in the first 6 months following stroke. METHOD: Using the Rivermead Assessment of Somatosensory Performance (RASP), the Motricity index and the Barthel Activities of Daily Living (ADL) index, a case series of serial somatosensory and motor measurements was made on 18 patients with a diagnosis of a first ever stroke. Patients comprised 2 distinct groups, acute and subacute. The acute group were seen weekly for the first month post onset and the subacute group were seen monthly for 6 months. Participants were seen at hospital, regional rehabilitation unit and/or the participant's home. Standard local rehabilitation was given. RESULTS: The somatosensory subtest of proprioception demonstrated the greatest level of recovery. No patient achieved full recovery on all somatosensory subtests. Motor and functional recovery demonstrated continual improvement over time, somatosensory recovery showed marked variation in subtests both within and between patients. CONCLUSION: Of the 18 patients tested there were no consistent, generalizable, recognizable patterns of sensory recovery demonstrated.

The Rivermead Assessment of Somatosensory Performance (RASP): standardization and reliability data.

OBJECTIVE: To develop a standardized, clinically relevant, quantitative assessment of somatosensory performance in patients with stroke. DESIGN: Prospective observational study and test evaluation. SETTING: Local Oxford hospitals and a regional neurological rehabilitation centre. SUBJECTS: Stroke patients with a first, lateralized acute stroke in hospital, and age-matched control subjects. METHOD: Each patient was assessed in a structured way using a new battery of formal tests of somatosensory performance. RESULTS: A total of 100 patients and 50 controls were fully investigated. Control subjects performed at or near ceiling on all tests, but patients showed impaired performance on all tests. The Rivermead Assessment of Somatosensory Performance (RASP) showed good intra-rater and inter-rater reliability for all subtests. There were however only weak relationships between scores of sensory impairment and scores of motor impairment or mobility and dependence. CONCLUSIONS: The RASP provides a practical and reliable assessment of sensory loss, which provides the clinician with a comprehensive picture of the patient's performance and can be used to inform and monitor rehabilitation and recovery.