Impaired hand function decreases quality of life after stroke. The purpose of this study was to pilot a novel two-week upper extremity sensorimotor training program. This case series describes the training program and highlights outcome measures used for documenting behavioral change and neural reorganization.

Sensorimotor evaluation identified behavioral changes, activity induced neural reorganization was examined using sensory fMRI, diffusion tensor tractography, and brain volume measurement. Participant 1 was a 75-year-old right-handed man one year post right hemisphere stroke with severe sensory impairment across domains in his left hand, he reported limited left hand/arm use. Participant 2 was a 63-year-old right-handed woman who had experienced a left hemisphere stroke 9 months earlier resulting in mild sensory impairment across domains in her right hand, as well as mild motor deficit.

Participants trained 4 hours per day, 5 days per week for two weeks. Training tasks required sensory discrimination of temperature, weights, textures, shapes and objects in the context of active exploration with the involved hand. Random multi-modal feedback was used.

Both participants had improved scores on the Wolf Motor Function Test after training. Participant 1 had no measureable change in sensory function, while Participant 2 improved in touch perception, proprioception and haptic performance. Sensory fMRI suggested neural reorganization in both participants; Participant 1 had a small increase in brain volume, while superior thalamic radiation white matter connectivity was unchanged in either participant.

Participating in sensorimotor training focused on sensory discrimination during manual manipulation was feasible for both participants. Future research to determine efficacy and identify optimal measures of sensory function and neural reorganization is recommended. Video Abstract available (see Video, Supplemental Digital Content 1) for more insights from the authors.