#81: Neurorrehabilitación somatosensorial en el ictus

En este episodio nos adentramos en una dimensión tan esencial como olvidada de la recuperación neurológica: la sensibilidad. Exploramos con profundidad la neurofisiología de los sistemas sensoriales, los tipos de sensibilidad, las vías implicadas y los déficits somatosensoriales que pueden aparecer tras un ictus. Hablamos de evaluación clínica y neurofisiológica, de escalas, de estereognosia, de patrones exploratorios, y de la implicación cortical tras una lesión. Abordamos también las principales intervenciones terapéuticas, desde la estimulación eléctrica sensitiva (SAES) hasta el entrenamiento activo sensitivo, repasando la evidencia más actual y las claves para una rehabilitación sensitiva eficaz. Referencias del episodio: 1. Bastos, V. S., Faria, C. D. C. M., Faria-Fortini, I., & Scianni, A. A. (2025). Prevalence of sensory impairments and its contribution to functional disability in individuals with acute stroke: A cross-sectional study. Revue neurologique, 181(3), 210–216. ( 2. Boccuni, L., Meyer, S., Kessner, S. S., De Bruyn, N., Essers, B., Cheng, B., Thomalla, G., Peeters, A., Sunaert, S., Duprez, T., Marinelli, L., Trompetto, C., Thijs, V., & Verheyden, G. (2018). Is There Full or Proportional Somatosensory Recovery in the Upper Limb After Stroke? Investigating Behavioral Outcome and Neural Correlates. Neurorehabilitation and neural repair, 32(8), 691–700. ( 3. Carey, L. M., Matyas, T. A., & Oke, L. E. (1993). Sensory loss in stroke patients: effective training of tactile and proprioceptive discrimination. Archives of physical medicine and rehabilitation, 74(6), 602–611. ( 4. Carey, L. M., Oke, L. E., & Matyas, T. A. (1996). Impaired limb position sense after stroke: a quantitative test for clinical use. Archives of physical medicine and rehabilitation, 77(12), 1271–1278. ( 5. Carey, L. M., & Matyas, T. A. (2005). Training of somatosensory discrimination after stroke: facilitation of stimulus generalization. American journal of physical medicine & rehabilitation, 84(6), 428–442. ( 6. Carey, L., Macdonell, R., & Matyas, T. A. (2011). SENSe: Study of the Effectiveness of Neurorehabilitation on Sensation: a randomized controlled trial. Neurorehabilitation and neural repair, 25(4), 304–313. ( 7. Carey, L. M., Abbott, D. F., Lamp, G., Puce, A., Seitz, R. J., & Donnan, G. A. (2016). Same Intervention-Different Reorganization: The Impact of Lesion Location on Training-Facilitated Somatosensory Recovery After Stroke. Neurorehabilitation and neural repair, 30(10), 988–1000. ( 8. Carey, L. M., Matyas, T. A., & Baum, C. (2018). Effects of Somatosensory Impairment on Participation After Stroke. The American journal of occupational therapy : official publication of the American Occupational Therapy Association, 72(3), 7203205100p1–7203205100p10. ( 9. Chilvers, M., Low, T., Rajashekar, D., & Dukelow, S. (2024). White matter disconnection impacts proprioception post-stroke. PloS one, 19(9), e0310312. ( 10. Conforto, A. B., Dos Anjos, S. M., Bernardo, W. M., Silva, A. A. D., Conti, J., Machado, A. G., & Cohen, L. G. (2018). Repetitive Peripheral Sensory Stimulation and Upper Limb Performance in Stroke: A Systematic Review and Meta-analysis. Neurorehabilitation and neural repair, 32(10), 863–871. ( 11. Cuesta, C. (2016). El procesamiento de la información somatosensorial y la funcionalidad de la mano en pacientes con daño cerebral adquirido ( 12. De Bruyn, N., Meyer, S., Kessner, S. S., Essers, B., Cheng, B., Thomalla, G., Peeters, A., Sunaert, S., Duprez, T., Thijs, V., Feys, H., Alaerts, K., & Verheyden, G. (2018). Functional network connectivity is altered in patients with upper limb somatosensory impairments in the acute phase post stroke: A cross-sectional study. PloS one, 13(10), e0205693. ( 13. De Bruyn, N., Saenen, L., Thijs, L., Van Gils, A., Ceulemans, E., Essers, B., Alaerts, K., & Verheyden, G. (2021). Brain connectivity alterations after additional sensorimotor or motor therapy for the upper limb in the early-phase post stroke: a randomized controlled trial. Brain communications, 3(2), fcab074. ( 14. Grant, V. M., Gibson, A., & Shields, N. (2018). Somatosensory stimulation to improve hand and upper limb function after stroke-a systematic review with meta-analyses. Topics in stroke rehabilitation, 25(2), 150–160. ( 15. Kessner, S. S., Schlemm, E., Cheng, B., Bingel, U., Fiehler, J., Gerloff, C., & Thomalla, G. (2019). Somatosensory Deficits After Ischemic Stroke. Stroke, 50(5), 1116–1123. ( 16. Ladera V, Perea MV. Agnosias auditivas, somáticas y táctiles. Rev Neuropsicol y Neurociencias. 2015;15(1):87–108 ( 17. Laufer, Y., & Elboim-Gabyzon, M. (2011). Does sensory transcutaneous electrical stimulation enhance motor recovery following a stroke? A systematic review. Neurorehabilitation and neural repair, 25(9), 799–809. ( 18. Lederman, S. J., & Klatzky, R. L. (1987). Hand movements: a window into haptic object recognition. Cognitive psychology, 19(3), 342–368. ( 19. Meyer, S., De Bruyn, N., Lafosse, C., Van Dijk, M., Michielsen, M., Thijs, L., Truyens, V., Oostra, K., Krumlinde-Sundholm, L., Peeters, A., Thijs, V., Feys, H., & Verheyden, G. (2016). Somatosensory Impairments in the Upper Limb Poststroke: Distribution and Association With Motor Function and Visuospatial Neglect. Neurorehabilitation and neural repair, 30(8), 731–742. ( 20. Miguel-Quesada, C., Zaforas, M., Herrera-Pérez, S., Lines, J., Fernández-López, E., Alonso-Calviño, E., Ardaya, M., Soria, F. N., Araque, A., Aguilar, J., & Rosa, J. M. (2023). Astrocytes adjust the dynamic range of cortical network activity to control modality-specific sensory information processing. Cell reports, 42(8), 112950. ( 21. Moore, R. T., Piitz, M. A., Singh, N., Dukelow, S. P., & Cluff, T. (2024). The independence of impairments in proprioception and visuomotor adaptation after stroke. Journal of neuroengineering and rehabilitation, 21(1), 81. ( 22. Opsommer, E., Zwissig, C., Korogod, N., & Weiss, T. (2016). Effectiveness of temporary deafferentation of the arm on somatosensory and motor functions following stroke: a systematic review. JBI database of systematic reviews and implementation reports, 14(12), 226–257. ( 23. Sharififar, S., Shuster, J. J., & Bishop, M. D. (2018). Adding electrical stimulation during standard rehabilitation after stroke to improve motor function. A systematic review and meta-analysis. Annals of physical and rehabilitation medicine, 61(5), 339–344. ( 24. Stolk-Hornsveld, F., Crow, J. L., Hendriks, E. P., van der Baan, R., & Harmeling-van der Wel, B. C. (2006). The Erasmus MC modifications to the (revised) Nottingham Sensory Assessment: a reliable somatosensory assessment measure for patients with intracranial disorders. Clinical rehabilitation, 20(2), 160–172. ( 25. Turville, M., Carey, L. M., Matyas, T. A., & Blennerhassett, J. (2017). Change in Functional Arm Use Is Associated With Somatosensory Skills After Sensory Retraining Poststroke. The American journal of occupational therapy : official publication of the American Occupational Therapy Association, 71(3), 7103190070p1–7103190070p9. ( 26. Turville, M. L., Cahill, L. S., Matyas, T. A., Blennerhassett, J. M., & Carey, L. M. (2019). The effectiveness of somatosensory retraining for improving sensory function in the arm following stroke: a systematic review. Clinical rehabilitation, 33(5), 834–846. ( 27. Villar Ortega, E., Buetler, K. A., Aksöz, E. A., & Marchal-Crespo, L. (2024). Enhancing touch sensibility with sensory electrical stimulation and sensory retraining. Journal of neuroengineering and rehabilitation, 21(1), 79. ( 28. Yilmazer, C., Boccuni, L., Thijs, L., & Verheyden, G. (2019). Effectiveness of somatosensory interventions on somatosensory, motor and functional outcomes in the upper limb post-stroke: A systematic review and meta-analysis. NeuroRehabilitation, 44(4), 459–477. ( 29. Zamarro-Rodríguez, B. D., Gómez-Martínez, M., & Cuesta-García, C. (2021). Validation of Spanish Erasmus-Modified Nottingham Sensory Assessment Stereognosis Scale in Acquired Brain Damage. International journal of environmental research and public health, 18(23), 12564. (

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#81: Neurorrehabilitación somatosensorial en el ictus is an episode from Hemispherics by Hemispherics.

This episode is 01:48:39 long.

This episode was published on Jul 26, 2025.

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