Comfortably numb? Experiences of people with stroke and lower limb sensation deficits: impact and solutions

Luckie, H. ORCID: https://orcid.org/0000-0002-0854-5406, Hollands, K. ORCID: https://orcid.org/0000-0002-3691-9532, Williamson, Tracey ORCID: https://orcid.org/0000-0002-7736-0712, Nester, C. ORCID: https://orcid.org/0000-0003-1688-320X and Williams, A. ORCID: https://orcid.org/0000-0003-1224-4347 (2020) Comfortably numb? Experiences of people with stroke and lower limb sensation deficits: impact and solutions. Disability and Rehabilitation: Assistive Technology, 16 (3). pp. 262-269. ISSN 1748-3107

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Abstract

Purpose: To explore personal experiences of loss of foot sensation following stroke in order to inform the focus of clinical assessments and development of a vibrotactile insole.
Methods: Qualitative design with an interpretive phenomenological approach to data collection and analysis. Eight community dwelling adults with stroke (>6 months) and sensory impairment in the feet participated. Data was collected via conversational style interviews which were transcribed and analyzed using a thematic framework. Themes were verified with co-researchers and a lay advisory group.
Results: Data formed four themes: Sensory deficits are prevalent and constant, but individual and variable; Sensory deficits have a direct impact on balance, gait, mobility and falls; Sensory deficits have consequences for peoples’ lives; Footwear is the link between function, the environment and identity. They embraced the concept of discrete vibrotactile insoles, their potential benefits and demonstrated a willingness to try it.
Conclusions: Sensory deficit contributes to effects upon physical function, mobility and activity. Clinical outcome measures need to capture the emotional, psychological and social impacts of sensory deficit. Participants demonstrated a resilience and resourcefulness through adaption in daily living and self-management of footwear. The participants focus on footwear provides the opportunity to develop discrete and non-burdensome vibrotactile insoles for this patient group.

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