Abstract
BackgroundWe examined the validity and reliability of a short robotic test of upper limb proprioception, the Arm Movement Detection (AMD) test, which yields a ratio-scaled, objective outcome measure to be used for evaluating the impact of sensory deficits on impairments of motor control, motor adaptation and functional recovery in stroke survivors.MethodsSubjects grasped the handle of a horizontal planar robot, with their arm and the robot hidden from view. The robot applied graded force perturbations, which produced small displacements of the handle. The AMD test required subjects to respond verbally to queries regarding whether or not they detected arm motions. Each participant completed ten, 60s trials; in five of the trials, force perturbations were increased in small increments until the participant detected motion while in the others, perturbations were decreased until the participant could no longer detect motion. The mean and standard deviation of the 10 movement detection thresholds were used to compute a Proprioceptive Acuity Score (PAS). Based on the sensitivity and consistency of the estimated thresholds, the PAS quantifies the likelihood that proprioception is intact. Lower PAS scores correspond to higher proprioceptive acuity. Thirty-nine participants completed the AMD test, consisting of 25 neurologically intact control participants (NIC), seven survivors of stroke with intact proprioception in the more affected limb (HSS+P), and seven survivors of stroke with impaired or absent proprioception in the more affected limb (HSS-P).ResultsSignificant group differences were found, with the NIC and HSS+P groups having lower (i.e., better) PAS scores than the HSS-P group. A subset of the participants completed the AMD test multiple times and the AMD test was found to be reliable across repetitions.ConclusionsThe AMD test required less than 15 min to complete and provided an objective, ratio-scaled measure of proprioceptive acuity in the upper limb. In the future, this test could be utilized to evaluate the contributions of sensory deficits to motor recovery following stroke.
Highlights
We examined the validity and reliability of a short robotic test of upper limb proprioception, the Arm Movement Detection (AMD) test, which yields a ratio-scaled, objective outcome measure to be used for evaluating the impact of sensory deficits on impairments of motor control, motor adaptation and functional recovery in stroke survivors
Our results reveal that the AMD test yields two performance measures, Proprioceptive Acuity Score (PAS) and mean threshold, which are differentially sensitive to changes in proprioceptive acuity due to aging and neuromotor injury consequent to stroke
The results of this study indicate that the Arm Movement Detection (AMD) test is a quick, sensitive, and repeatable method for quantifying proprioceptive acuity
Summary
We examined the validity and reliability of a short robotic test of upper limb proprioception, the Arm Movement Detection (AMD) test, which yields a ratio-scaled, objective outcome measure to be used for evaluating the impact of sensory deficits on impairments of motor control, motor adaptation and functional recovery in stroke survivors. Limb proprioception is the complex sensation of limb posture and movement [3] derived from multiple sensory receptors that signal the physical state of the limb (e.g., information about the configuration of the joints and changes in joint configuration). These receptors include mechanoreceptors in muscles, tendons, joints, and areas of skin overlying the joints (c.f., [47]). For example, the loss of upper extremity proprioceptive sensation can degrade sensorimotor control of actions vital to an independent life style [13, 40, 70], including reaching, stabilizing the limb, and manipulating objects [5, 53, 65, 69]
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