Assessment of sensory impairment of the upper limb post-stroke by occupational therapists within the acute setting: A mixed methods study exploring current clinical practice

Abstract

Introduction: Sensory impairment of the upper limb is common after stroke and negatively impacts a stroke survivor’s recovery. The acute phase is a critical time for the identification of post-stroke somatosensory impairments and occupational therapists have a key role in the acute stroke setting. Sensory assessment and treatment practices of occupational therapists working in acute stroke settings are largely unknown. This study aims to describe current clinical practice and identify the barriers and enablers for the assessment of sensory impairment in patients post stroke within acute stroke units. Method: A mixed-methods approach was utilised, with an Australian national cross-sectional online survey of occupational therapists (n = 85) and state-based focus groups (n = 2). Descriptive analyses and thematic analysis were conducted. Findings: The majority of clinicians (78%) use non-standardised measures to assess for somatosensory impairment. Three qualitative themes were identified: acute setting contextual factors, individual patient characteristics and priorities, and clinician knowledge and perceived benefits. Conclusion: Occupational therapists working within acute stroke units are aware of the importance of assessing sensory impairment of the upper limb post stroke. However, the majority use non-standardised approaches and called for a standardised quick-to-administer tool kit that is readily available in acute stroke units.