Abstract
Proprioceptive deficits after stroke are poorly understood. We examined how proprioceptive deficits affect bilateral arm capacity. Better understanding of how these deficits affect function can better inform clinical care and promote independence.
Primary Author and Speaker: Joanna E Hoh
Contributing Authors: Kenna C. Gilley, Jennifer A. Semrau, Darcy S. Reisman
Most occupations are completed bilaterally; however, hemiparesis after stroke affects bilateral function by compromising the relationship between the arms. Half of individuals are estimated to have proprioceptive deficits after stroke. The purpose of this study was to understand how proprioceptive deficits affect the relationship between clinical and robotic measures of bilateral arm capacity after stroke. We hypothesized 1) a positive relationship between clinical and robotic measures of bilateral arm activity and 2) individuals with proprioceptive deficits will have lower bilateral arm capacity. Participants with chronic, unilateral stroke were recruited for this cross-sectional, observational study. Clinical proprioception was assessed with the Thumb Localizer Test (TLT). Bilateral capacity was measured clinically using the Chedoke Arm and Hand Activity Inventory (CAHAI) and robotically using the Kinarm exoskeleton, where participants used both hands as equally as possible to interact in a virtual environment to hit falling objects away from the body. In our current sample (N = 8), 4 individuals had proprioceptive deficits (TLT>0). Preliminary results indicated that those with proprioceptive deficits generally had lower clinical bilateral arm capacity on the CAHAI (37.5, interquartile range (IQR) [27, 69]) compared to those without (84, IQR [54, 89]). Results were similar for robotic bilateral arm capacity as the paretic arm was less successful on the task compared to the non-paretic side for those with proprioceptive deficits (49%, IQR [47%, 88%]) compared to those without (79%, IQR [59%, 89%]). As occupational therapy practitioners, it is critical to assess bilateral function after stroke as it closely relates to functional independence. Proprioceptive deficits may impact bilateral arm capacity after stroke, and capturing upper limb proprioceptive deficits is an important aspect of clinical care as a contributor to overall arm function after stroke.
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