Objective Evaluation of Proprioceptive Perception of Single-Joint Arm Movements in Patients with Hemiparesis of Central Genesis

Abstract

Aim. Objective evaluation of proprioceptive perception of single-joint movements of the paretic arm in patients with unilateral brain damage using the method developed by us. Materials and Methods. Proprioceptive perception of pronation-supination of the forearm, flexion-extension in the shoulder, elbow and wrist joints and abduction-adduction in the shoulder and wrist joints was tested in 23 patients with right-sided and 17 patients with left-sided brain damage. The subject with his eyes closed was made to perform a series of passive cyclical test movements, during which he had to copy them with active movements of the other arm. Joint angles were recorded in the test joint and the same joint ofthe other arm. The integrity of proprioceptive sensitivity was judged by the degree of similarity between “active” and “passive” movements estimated by means of objective qualitative and quantitative indicators. Results. Proprioceptive deficiency was detected in 83% of patients with lesion in the right and in 71% of patients with lesion inthe left hemisphere, while the proportion of test movements that revealed a violation of proprioceptive perception was 1.4 times higher in the right-hemisphere patients than in the left-hemisphere patients. A significant part of proprioceptive impairments, – 80% when testing movements of more distal and 29% – proximal segments of the arm, was detected by the presence of qualitative copying errors. Conclusions. The method used made it possible to identify proprioceptive deficits in more than half of patients with damage to both the right and left hemispheres. Proprioceptive perception of movements of the distal arm segment suffered more often and was more pronounced than the proximal one. A significant part of distal segment proprioception disorders manifested themselves in the form of gross qualitative copying errors, which can be detected visually during testing, even without the use of recording equipment.