Correlation Between Joint Position Sense, Threshold To Detection of Passive Motion of The Knee Joint And Walking Speed of Post-Stroke Patient

Abstract

Background: Sensorimotor dysfunction such as muscle weakness, impaired sensation, changes in muscle tone, reduced movement control are common in stroke patients. Locomotion function requires continuous afferent sensory input. Impairment of sensory function can hinder the ability to recruit muscles during walking. Patients generally walk slowly, cadence, step and stride length are shorter and the double phase of support increases. Goal: Analyzing the correlation between the propioceptive function of the knee joint and walking speed in post-stroke patients, who are treated at the PMR Outpatient Clinic of Dr. Soetomo General Academic Hospital Surabaya. Methode: An observational analytic cross sectional study, nine subjects measured walking speed (10MWT), joint position sense (JPS) and threshold to detetction of passive motion (TTDPM) of the knee joint, in the period March -November 2020.. Results: There is a moderate correlation between 10MWT and JPS 15 0 on the non-paretic side (r 0.676; p=0.045) and JPS 30 0 on the paretic side (r 0.668; p=0.049). And there is a strong correlation between 10MWT and JPS 60 0 on the paretic side (r 0.824; p=0.006). However, there is no significant correlation between 10MWT and TTDPM. Conclusion:There is correlation between the propioceptive function of the knee joint and the walking speed of post-stroke patients. The smaller the percentage of joint position error, the stronger the correlation with walking speed.

Can We Target Close Therapeutic Goals in the Gait Re-Education Algorithm for Stroke Patients at the Beginning of the Rehabilitation Process?

“…Due to the occurrence of proprioception deficits in a large group of people after a stroke (approximately 50-60% of stroke survivors) and their association with mobility and balance disorders, our set of tests included the assessment of one of the proprioception components, which is joint position sense [31][32][33]. The patients' task during the JPS test was similar to the studies conducted by Imanawanto et al [34] and Hwang et al [35], restoring the position of 30° of knee flexion and then the position of 60° of knee flexion. However, unlike the above-mentioned researchers, we assessed the subjects in the prone position.…”

“…Both angles are related to the position of the knee joint in selected phases of gait. Additionally, an angle of 60 degrees is related to climbing and descending stairs or low steps (the angle depends, among other things, on the height of the step and the limb selected for measurement) [ 34 , 36 , 37 , 38 ]. We observed significantly worse results not only between the paretic and control limbs but also between the non-paretic and control limbs, which is consistent with the results obtained by other authors [ 34 , 35 ].…”

“…Additionally, an angle of 60 degrees is related to climbing and descending stairs or low steps (the angle depends, among other things, on the height of the step and the limb selected for measurement) [ 34 , 36 , 37 , 38 ]. We observed significantly worse results not only between the paretic and control limbs but also between the non-paretic and control limbs, which is consistent with the results obtained by other authors [ 34 , 35 ]. The average error for the paretic limb was 10.4 ± 7.8° (30° JPS) and 15.7 ± 12.5° (60° JPS); for the non-paretic limb, it was 9.6 ± 8.3° (30° JPS) and 13.2 ± 7.8° (60° JPS); and for the control group, it was 4.7 ± 2.9° (30° JPS) and 4.6 ± 3.0° (60° JPS).…”

“…Interestingly, for the 60° measurement, more significant errors in both limbs were observed in people after a stroke than in the 30° measurement. Imanawanto et al [ 34 ] indicated that there is a correlation between the proprioceptive function of the knee joint and the walking speed of post-stroke patients. According to this study, the smaller the percentage of the joint position error, the stronger the correlation with walking speed.…”