Method of Objective Assessment of Proprioceptive Perception of Leg and Foot Movements in Humans

Abstract

Previously, we developed a method for objective assessment of the state of proprioceptive perception of movements of the upper limb. In order to test this method for assessing the proprioceptive perception of lower limb movements, we studied the accuracy of copying with open and closed eyes a series of passive single-joint movements of the tested leg directly during their execution with the help of active movements of the other leg. Flexion-extension copying in the knee and ankle joints was studied in 30 healthy subjects for both legs and in 40 patients with unilateral stroke for the paretic leg. The accuracy of copying movements was assessed by recording the angles in the tested joint and the joint of the same name of the opposite limb using qualitative and quantitative objective indicators. It was shown that healthy subjects, both under visual control and without it, copy the passive movements of the right and left legs with high accuracy and almost simultaneously. Based on the study of the values of qualitative and quantitative indicators of copying accuracy, an objective conditional criterion for the preservation of proprioceptive perception of movements in the knee and ankle joints was formulated. In contrast to healthy subjects, in the group of patients, the results of copying with open and closed eyes were significantly different. In tests with open eyes, the copying of movements was qualitatively correct, which indicates that they understood the motor task of the test and were able to perform it with a conditionally healthy leg. In the absence of visual control, most of them either made gross errors in the transmission of the direction and number of the tested movements, or reproduced movements with a significant deterioration in accuracy (increased delays, shape distortion, etc.). It was shown that the proprioceptive perception of movements in the ankle joint was disturbed more often and more strongly than movements in the knee joint. In accordance with the developed conditional criterion of the norm, in 69% of patients there was a violation of the proprioceptive perception of movements in the knee and/or ankle joints.