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The independence of deficits in position sense and visually guided reaching following stroke

机译:位置缺陷的独立性和视觉引导下卒中

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Background Several studies have found correlations between proprioception and visuomotor function during stroke recovery, however two more recent studies have found no correlation. Unfortunately, most of the studies to date have been conducted with clinical assessments of sensation that are observer-based and have poor reliability. We have recently developed new tests to assess position sense and motor function using robotic technology. The present study was conducted to reassess the relationship between position sense and upper limb movement following stroke. Methods We assessed position sense and motor performance of 100 inpatient stroke rehabilitation subjects and 231 non-disabled controls. All subjects completed quantitative assessments of position sense (arm-position matching task) and motor performance (visually-guided reaching task) using the KINARM robotic device. Subjects also completed clinical assessments including handedness, vision, Purdue Pegboard, Chedoke-McMaster Stroke Assessment-Impairment Inventory and Functional Independence Measure (FIM). Neuroimaging documented lesion localization. Fisher’s exact probability tests were used to determine the relationship between performances on the arm-position matching and visually-guided reaching task. Pearson’s correlations were conducted to determine the relationship between robotically measured parameters and clinical assessments. Results Performance by individual subjects on the matching and reaching tasks was statistically independent (Fisher’s test, P<0.01). However, performance on the matching and reaching tasks both exhibited relationships with abilities in daily activities as measured by the FIM. Performance on the reaching task also displayed strong relationships with other clinical measures of motor impairment. Conclusions Our data support the concept that position sense deficits are functionally relevant and point to the importance of assessing proprioceptive and motor impairments independently when planning treatment strategies.
机译:背景几项研究已发现中风恢复期间本体感受与视觉运动功能之间的相关性,但是最近两项研究未发现相关性。不幸的是,迄今为止,大多数研究都是基于对感觉的临床评估进行的,这些评估基于观察者,并且可靠性较差。我们最近开发了新的测试,以使用机器人技术评估位置感和运动功能。进行本研究以重新评估中风后位置感和上肢运动之间的关系。方法我们评估了100名住院中风康复受试者和231名非残障对照的位置感觉和运动表现。所有受试者均使用KINARM机器人设备完成了位置感(手臂位置匹配任务)和运动表现(视觉引导的伸手任务)的定量评估。受试者还完成了临床评估,包括惯性,视力,Purdue Pegboard,Chedoke-McMaster中风评估-功能障碍量表和功能独立性评估(FIM)。神经影像学记录了病变的位置。 Fisher的精确概率测试用于确定手臂位置匹配的表现与视觉引导的到达任务之间的关系。进行了Pearson的相关性以确定机器人测量的参数与临床评估之间的关系。结果个体受试者在匹配和达成任务上的表现在统计学上是独立的(Fisher检验,P <0.01)。然而,根据FIM的测量,匹配任务和达成任务的绩效都表现出与日常活动能力的关系。达到任务的表现也显示出与其他运动障碍临床指标的密切关系。结论我们的数据支持以下观点:位置感觉缺陷在功能上相关,并指出了在规划治疗策略时独立评估本体感受和运动障碍的重要性。

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