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

Content Provider	Springer Nature : BioMed Central
Author	Rinderknecht, Mike D. Lambercy, Olivier Raible, Vanessa Büsching, Imke Sehle, Aida Liepert, Joachim Gassert, Roger
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.
Related Links	https://jneuroengrehab.biomedcentral.com/counter/pdf/10.1186/s12984-018-0387-6.pdf
Ending Page	15
Page Count	15
Starting Page	1
File Format	HTM / HTML
ISSN	17430003
DOI	10.1186/s12984-018-0387-6
Journal	Journal of NeuroEngineering and Rehabilitation
Issue Number	1
Volume Number	15
Language	English
Publisher	BioMed Central
Publisher Date	2018-06-07
Access Restriction	Open
Subject Keyword	Neurosciences Neurology Rehabilitation Medicine Biomedical Engineering and Bioengineering Difference threshold MCP Metacarpophalangeal joint Parameter Estimation by Sequential Testing Psychophysics Quantitative measurements Robot-assisted assessment Somatosensory function
Content Type	Text
Resource Type	Article
Subject	Health Informatics Rehabilitation
Journal Impact Factor	5.2/2023
5-Year Journal Impact Factor	5.6/2023

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