A Tablet-Based Tool for Accurate Measurement of Hand Proprioception After Stroke

Block, Hannah J.; Mirdamadi, Jasmine L.; Ryckman, Sydney N.; Lynch, Anna K.; Wilson, Reid; Udayan, Divya; Massie, Crystal L.

doi:10.1097/npt.0000000000000259

Cited by 5 publications

(5 citation statements)

References 62 publications

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“…For test positions in the horizontal dimension the sagittal position remained constant and vice versa. The test positions were determined with an adaptive staircase algorithm based on the Parameter Estimation by Sequential Testing method (PEST) (Block et al 2019;Hoseini et al 2015;Ostry et al 2010;Taylor and Creelman 1967). The first trial of each staircase began by moving the subject's hand to the visual reference, where it was held for 2 s and subjects received explicit knowledge that their hand was at the reference position (Wilson et al 2010;Wong et al 2011).…”

Section: Participantsmentioning

confidence: 99%

Somatosensory changes associated with motor skill learning

Mirdamadi

Block

2020

Journal of Neurophysiology

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Trial-and-error motor adaptation has been linked to somatosensory plasticity and shifts in proprioception (limb position sense). The role of sensory processing in motor skill learning is less understood. Unlike adaptation, skill learning involves the acquisition of new movement patterns in the absence of perturbation, with performance limited by the speed-accuracy trade-off. We investigated somatosensory changes during motor skill learning at the behavioral and neurophysiological levels. Twenty-eight healthy young adults practiced a maze-tracing task, guiding a robotic manipulandum through an irregular two-dimensional track featuring several abrupt turns. Practice occurred on days 1 and 2. Skill was assessed before practice on day 1 and again on day 3, with learning indicated by a shift in the speed-accuracy function between these assessments. Proprioceptive function was quantified with a passive two-alternative forced-choice task. In a subset of 15 participants, we measured short-latency afferent inhibition (SAI) to index somatosensory projections to motor cortex. We found that motor practice enhanced the speed-accuracy skill function ( F4,108 = 32.15, P < 0.001) and was associated with improved proprioceptive sensitivity at retention ( t22 = 24.75, P = 0.0031). Furthermore, SAI increased after training ( F1,14 = 5.41, P = 0.036). Interestingly, individuals with larger increases in SAI, reflecting enhanced somatosensory afference to motor cortex, demonstrated larger improvements in motor skill learning. These findings suggest that SAI may be an important functional mechanism for some aspect of motor skill learning. Further research is needed to test what parameters (task complexity, practice time, etc.) are specifically linked to somatosensory function. NEW & NOTEWORTHY Somatosensory processing has been implicated in motor adaptation, where performance recovers from a perturbation such as a force field. We investigated somatosensory function during motor skill learning, where a new motor pattern is acquired in the absence of perturbation. After skill practice, we found changes in proprioception and short-latency afferent inhibition (SAI), signifying somatosensory change at both the behavioral and neurophysiological levels. SAI may be an important functional mechanism by which individuals learn motor skills.

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Section: Participantsmentioning

confidence: 99%

Somatosensory changes associated with motor skill learning

Mirdamadi

Block

2020

Journal of Neurophysiology

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“…Although some technology devices have been reported as easy to use (Bimanual Planar Robot Manipulandum, Robotic Sensory Trainer, and Brief Kinesthesia Test), 21,43,44 they are more difficult to use in a clinical setting because of their costs, limited portability, and the training clinicians need to administer them. 38,42 Consequently, the clinical tests should preferably be considered for screening purposes during the initial stages of assessment to detect proprioception impairment. This is due to the floor and ceiling effects, ease of use, and lack of accuracy associated with the clinical tests.…”

Section: Discussionmentioning

confidence: 99%

“…However, the test-taking time associated with the clinical tests versus the technological devices is still at issue as this information was not included in the various articles reviewed. Although some technology devices have been reported as easy to use (Bimanual Planar Robot Manipulandum, Robotic Sensory Trainer, and Brief Kinesthesia Test),21,43,44 they are more difficult to use in a clinical setting because of their costs, limited portability, and the training clinicians need to administer them 38,42. Consequently, the clinical tests should preferably be considered for screening purposes during the initial stages of assessment to detect proprioception impairment.…”

Section: Discussionmentioning

confidence: 99%

“…Specificity (Sp) and sensitivity (Se) were thought to be better for the technological devices (eg, GradDT [Sp = 87%, Se = 79%] and StepDT [Sp = 75%, Se = 87%] compared with EmNSA-P 38 [Sp = 50%, Se = 46%]), with the exception of the clinical test PMDD, which was found to be as good as the technological device Tablet-Based Tool 42 for sensitivity and better for specificity (PMDD [Sp = 60%, Se = 75%] 38 Lima et al (2010) 36 Villepinte et al (2019) 39 Villepinte et al Tablet-Based Tool [Sp = 30%, Se = 75%]) (Table 4). Responsiveness was reported as moderate for the 2 tools studied (Brief Kinesthesia Test 43 [Effect Size = 0.47] and rNSA-P 40 [Standard Response Mean = 0.51]).…”

Section: Responsivenessmentioning

confidence: 99%

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Where Are We on Proprioception Assessment Tests Among Poststroke Individuals? A Systematic Review of Psychometric Properties

Jamal

Penisson

Rostagno

et al. 2022

Journal of Neurologic Physical Therapy

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Background and Purpose: Proprioception is often impaired in poststroke individuals. This is a significant issue since altered proprioception is associated with poorer physical function outcomes poststroke. However, there is limited consensus on the best tools for assessing proprioception and support for their widespread use by clinicians. The objective is to appraise the psychometric properties of each test used to assess proprioception in poststroke individuals. Methods: A systematic search was performed according to PRISMA guidelines using the databases MEDLINE, Cochrane Library, PEDro, DiTa, and BioMedicalCentral for articles published up to January 2021. Results: Sixteen studies of low methodological quality were included. Sixteen different proprioception assessment tests were extracted. The proprioception portion of the Fugl-Meyer Assessment Scale was found to be the most valid and reliable tool for screening patients in clinical settings. Although no real gold standard exists, the technological devices demonstrated better responsiveness and measurement accuracy than clinical tests. Technological devices might be more appropriate for assessing proprioception recovery or better suited for research purposes. Discussion and Conclusions: This review revealed low-quality articles and a paucity of tests with good psychometric properties available to clinicians to properly screen and assess all subcomponents of proprioception. In perspective, technological devices, such as robotic orthoses or muscle vibration, may provide the best potential for assessing the different subcomponents of proprioception. Further studies should be conducted to develop and investigate such approaches. Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A388

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“…Proprioception, superficial touch and temperature sensation losses are common [3] and the sensory impairments may affect the patient's ability to control and coordinate movement [1]. The proprioceptive senses, including static position sense and movement sense or kinesthesia, are critical for accurate movement, but are often impaired following stroke [4,5]. These deficits significantly contribute to the patient's motor disability and largely determine the degree of recovery [6,7].…”

Section: Introductionmentioning

confidence: 99%

Upper extremity sensory training after stroke

Samardzic

2021

Srp Arh Celok Lek

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Introduction. Stroke is one of the leading causes for disability worldwide. After stroke, the majority of stroke survivors experience significant arm-hand impairments and a decreased use of the paretic arm and hand in daily life. Tactile sensibility of the hand is essential for identifying objects and for motor performance. Despite important sensory contributions to normal and abnormal movement, research has predominantly focused on motor aspects of stroke recovery. In this paper, we present the effect of sensory stimulation program on arm sensation and motor recovery in subacute stroke. Case outline. In a 65 years old woman the sensibility stimulation program was administered in subacute phase of post-stroke rehabilitation, six weeks after stroke, involving active and passive somatosensory intervention, motor control, coordination, strength and balance exercises. The rehabilitation protocol was applied for four weeks, five times a week. On discharge, the results of physiotherapy assessment showed full recovery of her right arm and hand. Conclusion. This case report shows that precise assessment, problems identification and problem oriented somatosensory interventions can improve, for short period, functional motor performance of the arm involved in rehabilitation after stroke.

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A Tablet-Based Tool for Accurate Measurement of Hand Proprioception After Stroke

Cited by 5 publications

References 62 publications

Somatosensory changes associated with motor skill learning

Somatosensory changes associated with motor skill learning

Where Are We on Proprioception Assessment Tests Among Poststroke Individuals? A Systematic Review of Psychometric Properties

Upper extremity sensory training after stroke

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