Assessment of Proprioceptive Acuity in Patients with Stroke with Left Hemiplegia Compared to Healthy Controls

Abstract

Proprioceptive information from mechanoreceptors within muscles, tendons, and skin, gives rise to kinesthesia and the sense of joint position. This information is not only crucial for bodily awareness, but it also impacts voluntary motor control, the maintenance of muscle tone and posture. Cortical stroke is known to cause impairment of proprioception, thus diminishing motor learning, postural control, and the ability to carry out activities of daily life. In this research we obtained objective measures of wrist position sense to elucidate the extent of the proprioceptive deficits in patients with chronic stroke compared to healthy age-matched controls. In addition, we examined the relationship of wrist proprioceptive impairment with the degree of upper extremity motor dysfunction as measured by the Motor Evaluation Scale for Upper Extremity in Stroke Patients (MESUPES) (Van de Winckel et al., 2006). Eight patients with chronic stroke with left hemiplegia and eight healthy age- and gender-matched controls participated. Wrist position sense was assessed under two conditions: 1) an ipsilateral wrist joint position matching task requiring active movement to reproduce a reference position, and 2) a psychophysical discrimination threshold test, in which the wrist joint was passively rotated using a 3 degrees-of-freedom wrist robot. The results showed that, in comparison to healthy controls, patients with stroke demonstrated increased joint position error bias and variability during active matching (p's < .05) and highly elevated mean position sense threshold for passive displacement (p < .05). This study documents that cortical stroke is associated with proprioceptive deficit of the wrist/hand complex, which likely contributes to the observed fine motor deficits in this population.