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Journal of NeuroEngineering and Rehabilitation

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Open Access 01-12-2018 | Research

Reliability, validity, and clinical feasibility of a rapid and objective assessment of post-stroke deficits in hand proprioception

Authors: Mike D. Rinderknecht, Olivier Lambercy, Vanessa Raible, Imke Büsching, Aida Sehle, Joachim Liepert, Roger Gassert

Published in: Journal of NeuroEngineering and Rehabilitation | Issue 1/2018

Abstract

Background

Proprioceptive function can be affected after neurological injuries such as stroke. Severe and persistent proprioceptive impairments may be associated with a poor functional recovery after stroke. To better understand their role in the recovery process, and to improve diagnostics, prognostics, and the design of therapeutic interventions, it is essential to quantify proprioceptive deficits accurately and sensitively. However, current clinical assessments lack sensitivity due to ordinal scales and suffer from poor reliability and ceiling effects. Robotic technology offers new possibilities to address some of these limitations. Nevertheless, it is important to investigate the psychometric and clinimetric properties of technology-assisted assessments.

Methods

We present an automated robot-assisted assessment of proprioception at the level of the metacarpophalangeal joint, and evaluate its reliability, validity, and clinical feasibility in a study with 23 participants with stroke and an age-matched group of 29 neurologically intact controls. The assessment uses a two-alternative forced choice paradigm and an adaptive sampling procedure to identify objectively the difference threshold of angular joint position.

Results

Results revealed a good reliability (ICC(2,1) = 0.73) for assessing proprioception of the impaired hand of participants with stroke. Assessments showed similar task execution characteristics (e.g., number of trials and duration per trial) between participants with stroke and controls and a short administration time of approximately 12 min. A difference in proprioceptive function could be found between participants with a right hemisphere stroke and control subjects (p<0.001). Furthermore, we observed larger proprioceptive deficits in participants with a right hemisphere stroke compared to a left hemisphere stroke (p=0.028), despite the exclusion of participants with neglect. No meaningful correlation could be established with clinical scales for different modalities of somatosensation. We hypothesize that this is due to their low resolution and ceiling effects.

Conclusions

This study has demonstrated the assessment’s applicability in the impaired population and promising integration into clinical routine. In conclusion, the proposed assessment has the potential to become a powerful tool to investigate proprioceptive deficits in longitudinal studies as well as to inform and adjust sensorimotor rehabilitation to the patient’s deficits.

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Title: Reliability, validity, and clinical feasibility of a rapid and objective assessment of post-stroke deficits in hand proprioception
Authors: Mike D. Rinderknecht
Olivier Lambercy
Vanessa Raible
Imke Büsching
Aida Sehle
Joachim Liepert
Roger Gassert
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: Journal of NeuroEngineering and Rehabilitation / Issue 1/2018
Electronic ISSN: 1743-0003
DOI: https://doi.org/10.1186/s12984-018-0387-6

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Reliability, validity, and clinical feasibility of a rapid and objective assessment of post-stroke deficits in hand proprioception

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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