Abstract
BackgroundAccording to between-arms assessments, more than 50% of individuals with stroke have an impaired position sense. Our previous work, which employed a clinical assessment and slightly differing tasks, indicates that individuals who have a deficit on a between-forearms position-localization task do not necessarily have a deficit on a single-forearm position-localization task.ObjectiveOur goal here was to, using robotics tools, determine whether individuals with stroke who have a deficit when matching forearm positions within an arm also have a deficit when mirroring forearm positions between arms, independent of the arm that leads the task.MethodsEighteen participants with chronic hemiparetic stroke and nine controls completed a single-arm position-matching experiment and between-arms position-mirroring experiment. For each experiment, the reference forearm (left/right) passively rotated about the elbow joint to a reference target location (flexion/extension), and then the participant actively rotated their same/opposite forearm to match/mirror the reference forearm’s position. Participants with stroke were classified as having a position-matching/-mirroring deficit based on a quantitative threshold that was derived from the controls’ data.ResultsOn our single-arm task, one participant with stroke was classified as having a position-matching deficit with a mean magnitude of error greater than 10.7° when referencing their paretic arm. Position-matching ability did not significantly differ for the controls and the remaining seventeen participants with stroke. On our between-arms task, seven participants with stroke were classified as having a position-mirroring deficit with a mean magnitude of error greater than 10.1°. Position-mirroring accuracy was worse for these participants with stroke, when referencing their paretic arm, than the controls.Concluding remarkFindings underscore the need for assessing within-arm position-matching deficits, in addition to between-arms position-mirroring deficits when referencing each arm, to comprehensively evaluate an individual’s ability to locate their forearm(s).
Highlights
By 2030 approximately 8.4 million American adults are projected to have survived a stroke [1], and current literature suggests that upwards of 50% of these survivors may have an inability to locate their limb(s) in space [2, 3]
Individuals with chronic hemiparetic stroke locate their forearms during single-arm and between-arms tasks participants with stroke were classified as having a position-mirroring deficit with a mean magnitude of error greater than 10.1 ̊
Purely passive or purely active movements were employed on the single-arm task, yet a combination of passive and active movements were employed on the between-arms task
Summary
By 2030 approximately 8.4 million American adults are projected to have survived a stroke [1], and current literature suggests that upwards of 50% of these survivors may have an inability to locate their limb(s) in space [2, 3]. We hypothesize that the deficit arose due to the: i) comparison of inaccurate position information relayed from either/both arm(s) and/or ii) inaccurate processing of accurate position information that was relayed from either/both arm(s) Our findings in this earlier study, showed that while participants with stroke did not significantly differ from controls when matching positions within each arm if they controlled how their forearm moved (i.e., active movements), participants with stroke had a slightly greater variability than controls when matching positions if their forearm was moved for them (i.e., passive movements). Our previous work, which employed a clinical assessment and slightly differing tasks, indicates that individuals who have a deficit on a between-forearms position-localization task do not necessarily have a deficit on a single-forearm position-localization task
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