Perceptual disorders after stroke: a scoping review of interventions

Hazelton, C. et al. (2022) Perceptual disorders after stroke: a scoping review of interventions. Stroke, 53(5), pp. 1772-1787. (doi: 10.1161/STROKEAHA.121.035671) (PMID:35468001) (PMCID:35468001)

Abstract

Perceptual disorders relating to hearing, smell, somatosensation, taste, touch, and vision commonly impair stroke survivors’ ability to interpret sensory information, impacting on their ability to interact with the world. We aimed to identify and summarize the existing evidence for perceptual disorder interventions poststroke and identify evidence gaps. We searched 13 electronic databases including MEDLINE and Embase and Grey literature and performed citation tracking. Two authors independently applied a priori–defined selection criteria; studies involving stroke survivors with perceptual impairments and interventions addressing those impairments were included. We extracted data on study design, population, perceptual disorders, interventions, and outcomes. Data were tabulated and synthesized narratively. Stroke survivors, carers, and clinicians were involved in agreeing definitions and organizing and interpreting data. From 91 869 records, 80 studies were identified (888 adults and 5 children); participant numbers were small (median, 3.5; range, 1–80), with a broad range of stroke types and time points. Primarily focused on vision (34/80, 42.5%) and somatosensation (28/80; 35.0%), included studies were often case reports (36/80; 45.0%) or randomized controlled trials (22/80; 27.5%). Rehabilitation approaches (78/93; 83.9%), primarily aimed to restore function, and were delivered by clinicians (30/78; 38.5%) or technology (28/78; 35.9%; including robotic interventions for somatosensory disorders). Pharmacological (6/93; 6.5%) and noninvasive brain stimulation (7/93; 7.5%) approaches were also evident. Intervention delivery was poorly reported, but most were delivered in hospital settings (56/93; 60.2%). Study outcomes failed to assess the transfer of training to daily life. Interventions for stroke-related perceptual disorders are underresearched, particularly for pediatric populations. Evidence gaps include interventions for disorders of hearing, taste, touch, and smell perception. Future studies must involve key stakeholders and report this fully. Optimization of intervention design, evaluation, and reporting is required, to support the development of effective, acceptable, and implementable interventions.

• Item Type: Articles
• Additional Information: This project is funded by the National Institute for Health Research (NIHR; NIHR Health Technology Assessment [NIHR 128829]) and will be published in full in the NIHR Journals Library. Further information is available at https://fundingawards. nihr.ac.uk/award/NIHR128829. Dr Hazelton is funded by the Stroke Association (TSA), UK (SA L-NC 20\100003); NMAHP RU and Dr Brady is funded by the Chief Scientist Office (CSO), Health and Social Care Directorates, United Kingdom.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Dorris, Professor Liam
• Authors: Hazelton, C., McGill, K., Campbell, P., Todhunter-Brown, A., Thomson, K., Nicolson, D. J., Cheyne, J. D., Chung, C., Dorris, L., Gillespie, D. C., Hunter, S. M., and Brady, M. C.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care
• Journal Name: Stroke
• Publisher: American Heart Association
• ISSN: 0039-2499
• ISSN (Online): 1524-4628
• Published Online: 25 April 2022
• Copyright Holders: Copyright © 2022 The Authors
• First Published: First published in Stroke 53(5):1772-1787
• Publisher Policy: Reproduced under a Creative Commons License