Abstract TP91: Post-Stroke Assessment of Kinaesthesia with and without Vision using Robotics
Stroke can lead to damage of brain regions and pathways involved in sensory processing of limb afferent and visual signals. While stroke rehabilitation research often focuses on motor recovery, there is limited knowledge about the prevalence of proprioceptive deficits and their impact on sensorimotor capabilities. The present study characterizes the presence of kinaesthetic (sense of motion) deficits and the ability of individuals to correct for these deficits with vision after stroke.
Individuals with subacute stroke (N = 107, median age = 59) and non-disabled controls (N = 101, median age = 47.5) performed a kinaesthetic matching task with and without vision using a robotic exoskeleton. The robotic exoskeleton passively moved the stroke patients’ affected arm at a preset speed, direction and magnitude of movement. Subjects were instructed to mirror-match the speed, direction and magnitude of the movement as soon as they felt the robot begin to move their affected arm. Stroke subjects also completed a standardized clinical assessment including vision screening, Behavioural Inattention Test (median ± SD = 141 ± 29.71), Chedoke McMaster Stroke Assessment - Impairment Inventory of Arm (5 ± 2.61) and Hand (5 ± 2.49) and Functional Independence Measure (FIM) (95.21 ± 23.54).
As compared to controls, 49% of subjects with stroke displayed larger initial direction errors when performing the task without vision. When vision was provided 25% of these subjects now performed within the control range. Surprisingly, 24% of subjects performed worse with vision. A similar pattern of impairments were observed for movement reaction time. As a group, subjects with field defects and/or hemineglect displayed significantly greater impairments than the rest of the subjects with stroke.
Our results suggest that kinaesthetic deficits are highly prevalent amongst patients who have had a stroke. The quantification and identification of these sensory deficits using the robotic technology has significant potential for improving diagnosis and prognosis of sensory and motor deficits and performance in daily activities.
- © 2012 by American Heart Association, Inc.