This randomized controlled trial investigated the comparative effects of sensory, motor, and combined sensorimotor interventions on hand motor function and behavioral performance in patients with stroke. The study focused on upper-extremity impairments, particularly deficits in hand strength, dexterity, and reaction time, which are common following stroke and substantially limit functional independence. Sensorimotor integration plays a critical role in motor recovery, as effective hand function depends on the interaction between sensory feedback and motor control mechanisms. Participants with stroke were randomly assigned to sensory, motor, or combined sensorimotor intervention groups. The interventions were designed to target tactile perception, motor coordination, and integrated sensorimotor processing through attended active and passive stimulation approaches. Outcome measures included hand grip strength, manual dexterity, and reaction time, which were evaluated before and after the intervention period. The findings demonstrated that sensorimotor-based rehabilitation approaches positively influenced upper-extremity motor performance and behavioral responses in stroke patients. In particular, combined sensorimotor interventions appeared to provide more comprehensive improvements by simultaneously enhancing sensory processing and motor execution. These results support the importance of integrating sensory-focused strategies into conventional motor rehabilitation programs to optimize neuroplasticity and functional recovery after stroke. The study contributes to the growing evidence supporting multidimensional rehabilitation approaches for improving hand function and sensorimotor performance in individuals with stroke.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
SINGLE
Enrollment
81
In the Combined Sensorimotor Group (CSMG), sensory and motor exercises were applied according to the protocols used in the Sensory Exercise Group (SEG) and Motor Exercise Group (MEG). However, each exercise was performed as a single set, with the remaining session time allocated to superficial massage and sensory stimulation. The sensory and motor components were administered sequentially, with each phase lasting approximately 7-8 minutes to maintain temporal balance within the session.
The Sensory Exercise Group (SEG) participated in an intervention designed to enhance sensory awareness and integration. The protocol included tactile stimuli such as sand, sensory balls, fabrics with different textures, multisensory gels, brushing, vibration, and superficial massage to stimulate cutaneous receptors and enrich sensory input. Massage was applied with the participant in a supine position, elbows extended, and hands in a neutral position. All sessions were standardized using a digital stopwatch, and each intervention lasted approximately 15 minutes with equal time allocation across groups. This standardized timing ensured that observed effects were related to the intervention content rather than differences in exposure duration.
The Motor Exercise Group (MEG) performed structured hand exercises including active range of motion exercises for the wrist and fingers, grip strengthening, stabilization exercises, and wrist flexion-extension exercises using elastic bands and dumbbells. Resistance levels were adjusted according to participant tolerance, and the protocol was applied only to the dominant side. Each exercise consisted of 5-7 repetitions and two sets, with 30-second rest intervals between sets.
Istanbul Atlas University
Kâğıthane, Istanbul, Turkey (Türkiye)
Moberg Pick-up Test (MPUT)
Hand function was evaluated using the Moberg Pick-up Test (MPUT), a standardized method for assessing functional hand use and fine-motor skills, specifically measuring the ability to grasp and manipulate small objects. During the test, participants were instructed to pick up various small objects (e.g., coins and small blocks) and place them in a container as quickly as possible. During the test, the participants were instructed to pick up various small objects and place them in a container as quickly as possible. The assessment was conducted with the dominant hand, first with eyes open and then with eyes closed, to test sensory function. For each condition, the test was repeated three times, and the best performance time, recorded in seconds, was used for analysis. The objects used in the test were of similar size and required coordinated hand movements for successful completion, ensuring consistency in task difficulty
Time frame: immediately after the intervention
Muscle Reaction Time
Light Trainer® system, which consists of a wireless lighting system with LED pods and a central controller. The participants were seated with their hands on the table, 40 cm apart, palms down, and elbows at 90°. The Light Trainer was positioned centrally 20 cm away from each hand. When the pod was illuminated, the participants were instructed to turn off the light as quickly as possible by touching it. Light activation was randomized to avoid predictability, requiring participants to respond based on light cues each time. In the first task, the participants used their dominant hand to turn off the light as quickly as possible. In the second task, they responded to a light signal by deactivating a predetermined light from two different colors using their dominant hand. Scale Range: No minimum or maximum value in milliseconds (lower time is better). Interpretation: Lower reaction times signify better outcomes, as they reflect faster muscle response to visual stimuli.
Time frame: immediately after the intervention
Grip Strength (Measured Using Jamar Electronic Dynamometer)
Hand performance was assessed based on grip strength using a Takei Handheld Dynamometer (Takei Scientific Instruments Co., Tokyo, Japan). Participants were seated with elbows flexed at 90 degrees and forearms in a neutral position, and were instructed to squeeze the dynamometer with maximum force for 3-5 seconds, with the palm facing upwards. Each hand was tested three times with a 20-second rest between trials, and the highest value was recorded. This protocol ensures standardized and consistent results, with measurements documented in kilograms (kg) to provide reliable grip strength assessment. Scale Range: The dynamometer measures from 0 to 90 kg. Interpretation: Higher scores reflect stronger grip strength, which is indicative of better hand function.
Time frame: immediately after the intervention
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