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Journal of NeuroEngineering and Rehabilitation
Published in: Journal of NeuroEngineering and Rehabilitation 1/2017

Open Access 01-12-2017 | Research

Kinesthetic deficits after perinatal stroke: robotic measurement in hemiparetic children

Authors: Andrea M. Kuczynski, Jennifer A. Semrau, Adam Kirton, Sean P. Dukelow

Published in: Journal of NeuroEngineering and Rehabilitation | Issue 1/2017

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Abstract

Background

While sensory dysfunction is common in children with hemiparetic cerebral palsy (CP) secondary to perinatal stroke, it is an understudied contributor to disability with limited objective measurement tools. Robotic technology offers the potential to objectively measure complex sensorimotor function but has been understudied in perinatal stroke. The present study aimed to quantify kinesthetic deficits in hemiparetic children with perinatal stroke and determine their association with clinical function.

Methods

Case–control study. Participants were 6–19 years of age. Stroke participants had MRI confirmed unilateral perinatal arterial ischemic stroke or periventricular venous infarction, and symptomatic hemiparetic cerebral palsy. Participants completed a robotic assessment of upper extremity kinesthesia using a robotic exoskeleton (KINARM). Four kinesthetic parameters (response latency, initial direction error, peak speed ratio, and path length ratio) and their variabilities were measured with and without vision. Robotic outcomes were compared across stroke groups and controls and to clinical measures of sensorimotor function.

Results

Forty-three stroke participants (23 arterial, 20 venous, median age 12 years, 42% female) were compared to 106 healthy controls. Stroke cases displayed significantly impaired kinesthesia that remained when vision was restored. Kinesthesia was more impaired in arterial versus venous lesions and correlated with clinical measures.

Conclusions

Robotic assessment of kinesthesia is feasible in children with perinatal stroke. Kinesthetic impairment is common and associated with stroke type. Failure to correct with vision suggests sensory network dysfunction.
Literature
1.
Sherrington C. On the proprioceptive system, especially in its reflex aspect. Brain. 1907;29:467–82.CrossRef
2.
McCloskey DI. Kinesthetic sensibility. Physiol Rev. 1978;58:763–820.PubMed
3.
Gandevia SC, Refshauge KM, Collins DF. Proprioception: peripheral inputs and perceptual interactions. Adv Exp Med Biol. 2002;508:61–8.CrossRefPubMed
4.
Sainburg RL, Ghilardi MF, Poizner H, Ghez C. Control of limb dynamics in normal subjects and patients without proprioception. J Neurophysiol. 1995;73:820–35.PubMed
5.
Gordon J, Ghilardi MF, Ghez C. Impairments of reaching movements in patients without proprioception. I Spatial errors. J Neurophysiol. 1995;73:347–60.PubMed
6.
Feys H, De WW, Nuyens G, van de WA, Selz B, Kiekens C. Predicting motor recovery of the upper limb after stroke rehabilitation: value of a clinical examination. Physiother Res Int. 2000;5:1–18.CrossRefPubMed
7.
Semrau JA, Herter TM, Scott SH, Dukelow SP. Robotic identification of kinesthetic deficits after stroke. Stroke J Cereb Circ. 2013;44:3414–21.CrossRef
8.
Semrau JA, Wang JC, Herter TM, Scott SH, Dukelow SP. Relationship between visuospatial neglect and kinesthetic deficits after stroke. Neurorehabil Neural Repair. 2015;29:318–28.CrossRefPubMed
9.
Connell LA, Lincoln NB, Radford KA. Somatosensory impairment after stroke: frequency of different deficits and their recovery. Clin Rehabil. 2008;22:758–67.CrossRefPubMed
10.
Raju TN, Nelson KB, Ferriero D, Lynch JK. Ischemic perinatal stroke: summary of a workshop sponsored by the National Institute of Child Health and Human Development and the National Institute of Neurological Disorders and Stroke. Pediatrics. 2007;120:609–16.CrossRefPubMed
11.
Kirton A, deVeber G, Pontigon AM, MacGregor D, Shroff M. Presumed perinatal ischemic stroke: vascular classification predicts outcomes. Ann Neurol. 2008;63:436–43.CrossRefPubMed
12.
Kirton A. Predicting developmental plasticity after perinatal stroke. Dev Med Child Neurol. 2013;55(8):681–2.PubMed
13.
Tizard JP, Paine RS, Crothers B. Disturbances of sensation in children with hemiplegia. J Am Med Assoc. 1954;155:628–32.CrossRefPubMed
14.
Van Heest AE, House J, Putnam M. Sensibility deficiencies in the hands of children with spastic hemiplegia. JHand SurgAm. 1993;18:278–81.
15.
Brown JV, Schumacher U, Rohlmann A, Ettlinger G, Schmidt RC, Skreczek W. Aimed movements to visual targets in hemiplegic and normal children: is the “good” hand of children with infantile hemiplegia also normal? Neuropsychologia. 1989;27:283–302.CrossRefPubMed
16.
Kuczynski AM, Dukelow SP, Semrau JA, Kirton A. Robotic quantification of position sense in children with perinatal stroke. Neurorehabil Neural Repair. 2016;30(8):762–72.CrossRefPubMed
17.
Bleyenheuft Y, Gordon AM. Precision grip control, sensory impairments and their interactions in children with hemiplegic cerebral palsy: a systematic review. Res Dev Disabil. 2013;34:3014–28.CrossRefPubMed
18.
Cooper J, Majnemer A, Rosenblatt B, Birnbaum R. The determination of sensory deficits in children with hemiplegic cerebral palsy. J Child Neurol. 1995;10:300–9.CrossRefPubMed
19.
Goble DJ, Hurvitz EA, Brown SH. Deficits in the ability to use proprioceptive feedback in children with hemiplegic cerebral palsy. Int J Rehabil Res. 2009;32:267–9.CrossRefPubMed
20.
Pickett K, Konczak J. Measuring kinaesthetic sensitivity in typically developing children. Dev Med Child Neurol. 2009;51:711–6.CrossRefPubMed
21.
Bairstow PJ, Laszlo JI. Kinaesthetic sensitivity to passive movements and its relationship to motor development and motor control. Dev Med Child Neurol. 1981;23:606–16.CrossRefPubMed
22.
Elliott JM, Connolly KJ, Doyle AJ. Development of kinaesthetic sensitivity and motor performance in children. Dev Med Child Neurol. 1988;30:80–92.CrossRefPubMed
23.
Lincoln N. The unreliability of sensory assessments. Clin Rehabil. 1991;5:273–82.
24.
Coderre AM, Zeid AA, Dukelow SP, Demmer MJ, Moore KD, Demers MJ, et al. Assessment of upper-limb sensorimotor function of subacute stroke patients using visually guided reaching. Neurorehabil Neural Repair. 2010;24(6):528–41.CrossRefPubMed
25.
Dukelow SP, Herter TM, Moore KD, Demers MJ, Glasgow JI, Bagg SD, et al. Quantitative assessment of limb position sense following stroke. Neurorehabil Neural Repair. 2010;24:178–87.CrossRefPubMed
26.
Dukelow SP, Herter TM, Bagg SD, Scott SH. The independence of deficits in position sense and visually guided reaching following stroke. J Neuroengineering Rehabil. 2012;9:72.CrossRef
27.
Hughes CML, Tommasino P, Budhota A, Campolo D. Upper extremity proprioception in healthy aging and stroke populations, and the effects of therapist- and robot-based rehabilitation therapies on proprioceptive function. Front Hum Neurosci. 2015;9:120.CrossRefPubMedPubMedCentral
28.
Volpe BT, Huerta PT, Zipse JL, Rykman A, Edwards D, Dipietro L, et al. Robotic devices as therapeutic and diagnostic tools for stroke recovery. Arch Neurol. 2009;66:1086–90.CrossRefPubMed
29.
Maciejasz P, Eschweiler J, Gerlach-Hahn K, Jansen-Troy A, Leonhardt S. A survey on robotic devices for upper limb rehabilitation. J Neuroengineering Rehabil. 2014;11:3.CrossRef
30.
Garraway WM, Akhtar AJ, Gore SM, Prescott RJ, Smith RG. Observer variation in the clinical assessment of stroke. Age Ageing. 1976;5:233–40.CrossRefPubMed
31.
Carey LM, Oke LE, Matyas TA. Impaired limb position sense after stroke: a quantitative test for clinical use. Arch Phys Med Rehabil. 1996;77:1271–8.CrossRefPubMed
32.
Kitchen L, Westmacott R, Friefeld S, MacGregor D, Curtis R, Allen A, et al. The pediatric stroke outcome measure: a validation and reliability study. Stroke. 2012;43:1602–8.CrossRefPubMed
33.
Eliasson AC, Krumlinde-sundholm L, Rosblad B, Beckung E, Arner M, Ohrvall AM, et al. The Manual Ability Classification System (MACS) for children with cerebral palsy: scale development and evidence of validity and reliability. Dev Med Child Neurol. 2006;48:549–54.CrossRefPubMed
34.
Bohannon RW, Smith MB. Interrater reliability of a modified Ashworth scale of muscle spasticity. Phys Ther. 1987;67:206–7.CrossRefPubMed
35.
Hirayama K, Fukutake T, Kawamura M. “Thumb localizing test” for detecting a lesion in the posterior column-medial lemniscal system. J Neurol Sci. 1999;167:45–9.CrossRefPubMed
36.
Krumlinde-sundholm L, Holmefur M, Kottorp A, Eliasson AC. The Assisting Hand Assessment: current evidence of validity, reliability, and responsiveness to change. Dev Med Child Neurol. 2007;49:259–64.CrossRefPubMed
37.
Barreca SR, Stratford PW, Lambert CL, Masters LM, Streiner DL. Test-retest reliability, validity, and sensitivity of the Chedoke arm and hand activity inventory: a new measure of upper-limb function for survivors of stroke. Arch Phys Med Rehabil. 2005;86:1616–22.CrossRefPubMed
38.
Tiffin J, Asher EJ. The Purdue pegboard; norms and studies of reliability and validity. J Appl Psychol. 1948;32:234–47.CrossRefPubMed
39.
Oldfield RC. The assessment and analysis of handedness: the Edinburgh inventory. Neuropsychologia. 1971;9:97–113.CrossRefPubMed
40.
Wilson B, Cockburn J, Halligan P. Development of a behavioral test of visuospatial neglect. Arch Phys Med Rehabil. 1998;68:98–102.
41.
Boyd R, Sakzewski L, Ziviani J, Abbott DF, Badawy R, Gilmore R, et al. INCITE: a randomised trial comparing constraint induced movement therapy and bimanual training in children with congenital hemiplegia. BMC Neurol. 2010;10:4.CrossRefPubMedPubMedCentral
42.
Doyle S, Bennett S, Fasoli SE, McKenna KT. Interventions for sensory impairment in the upper limb after stroke. Cochrane Database Syst Rev. 2010;6:CD006331.
43.
Goble DJ, Aaron MB, Warschausky S, Kaufman JN, Hurvitz EA. The influence of spatial working memory on ipsilateral remembered proprioceptive matching in adults with cerebral palsy. Exp Brain Res. 2012;223:259–69.CrossRefPubMed
44.
Debert CT, Herter TM, Scott SH, Dukelow S. Robotic assessment of sensorimotor deficits after traumatic brain injury. J Neurol Phys Ther JNPT. 2012;36:58–67.CrossRefPubMed
45.
Scott SH, Dukelow SP. Potential of robots as next-generation technology for clinical assessment of neurological disorders and upper-limb therapy. J Rehabil Res Dev. 2011;48:335–53.CrossRefPubMed
46.
Fasoli SE, Ladenheim B, Mast J, Krebs HI. New horizons for robot-assisted therapy in pediatrics. Am J Phys Med Rehabil Assoc Acad Physiatr. 2012;91:S280–289.CrossRef
47.
Visser J, Geuze RH. Kinaesthetic acuity in adolescent boys: a longitudinal study. Dev Med Child Neurol. 2000;42:93–6.CrossRefPubMed
48.
Tamnes CK, Ostby Y, Fjell AM, Westlye LT, Due-Tønnessen P, Walhovd KB. Brain maturation in adolescence and young adulthood: regional age-related changes in cortical thickness and white matter volume and microstructure. Cereb Cortex N Y N 1991. 2010;20:534–48.
49.
Lebel C, Walker L, Leemans A, Phillips L, Beaulieu C. Microstructural maturation of the human brain from childhood to adulthood. Neuroimage. 2008;40:1044–55.CrossRefPubMed
50.
Smorenburg ARP, Ledebt A, Deconinck FJA, Savelsbergh GJP. Visual feedback of the non-moving limb improves active joint-position sense of the impaired limb in Spastic Hemiparetic Cerebral Palsy. Res Dev Disabil. 2011;32:1107–16.CrossRefPubMed
51.
Goodale MA, Westwood DA, Milner AD. Two distinct modes of control for object-directed action. Prog Brain Res. 2004;144:131–44.CrossRefPubMed
52.
Goble DJ, Brown SH. The biological and behavioral basis of upper limb asymmetries in sensorimotor performance. Neurosci Biobehav Rev. 2008;32:598–610.CrossRefPubMed
53.
Schabrun SM, Hillier S. Evidence for the retraining of sensation after stroke: a systematic review. Clin Rehabil. 2009;23:27–39.CrossRefPubMed
54.
Scott SH. The computational and neural basis of voluntary motor control and planning. Trends Cogn Sci. 2012;16:541–9.CrossRefPubMed
55.
Schaefer SY, Haaland KY, Sainburg RL. Hemispheric specialization and functional impact of ipsilesional deficits in movement coordination and accuracy. Neuropsychologia. 2009;47:2953–66.CrossRefPubMedPubMedCentral
56.
Schaefer SY, Haaland KY, Sainburg RL. Ipsilesional motor deficits following stroke reflect hemispheric specializations for movement control. Brain J Neurol. 2007;130:2146–58.CrossRef
57.
Kenzie JM, Semrau JA, Findlater SE, Yu AY, Desai JA, Herter TM, et al. Localization of Impaired Kinesthetic Processing Post-stroke. Front Hum Neurosci. 2016;10:505.CrossRefPubMedPubMedCentral
58.
Riquelme I, Padrón I, Cifre I, González-Roldán AM, Montoya P. Differences in somatosensory processing due to dominant hemispheric motor impairment in cerebral palsy. BMC Neurosci. 2014;15:10.CrossRefPubMedPubMedCentral
59.
60.
Goble DJ, Brown SH. Task-dependent asymmetries in the utilization of proprioceptive feedback for goal-directed movement. Exp Brain Res. 2007;180:693–704.CrossRefPubMed
61.
Kennard MA. Age and other factors in motor recovery from precentral lesions in monkeys. Am J Physiol. 1936;115:137–46.
62.
Hoon AH, Stashinko EE, Nagae LM, Lin DDM, Keller J, Bastian A, et al. Sensory and motor deficits in children with cerebral palsy born preterm correlate with diffusion tensor imaging abnormalities in thalamocortical pathways. Dev Med Child Neurol. 2009;51:697–704.CrossRefPubMed
63.
Hoon AH, Lawrie WT, Melhem ER, Reinhardt EM, Van Zijl PCM, Solaiyappan M, et al. Diffusion tensor imaging of periventricular leukomalacia shows affected sensory cortex white matter pathways. Neurology. 2002;59:752–6.CrossRefPubMed
64.
65.
Aman JE, Elangovan N, Yeh I-L, Konczak J. The effectiveness of proprioceptive training for improving motor function: a systematic review. Front Hum Neurosci. 2014;8:1075.PubMed
Metadata
Title
Kinesthetic deficits after perinatal stroke: robotic measurement in hemiparetic children
Authors
Andrea M. Kuczynski
Jennifer A. Semrau
Adam Kirton
Sean P. Dukelow
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Journal of NeuroEngineering and Rehabilitation / Issue 1/2017
Electronic ISSN: 1743-0003
DOI
https://doi.org/10.1186/s12984-017-0221-6

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