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. 2022 Dec 23;13(1):31.
doi: 10.3390/brainsci13010031.

Wrist Proprioception in Adults with and without Subacute Stroke

Brittany M Young  1   2 , Rishika Yadav  1   2 , Shivam Rana  1   2 , Won-Seok Kim  2   3 , Camellia Liu  1   2 , Rajan Batth  1   2 , Shivani Sakthi  1   2 , Eden Farahmand  1   2 , Simon Han  1   2 , Darshan Patel  1   2 , Jason Luo  1   2 , Christina Ramsey  1   2 , Marc Feldman  2 , Isabel Cardoso-Ferreira  2 , Christina Holl  1   2 , Tiffany Nguyen  1   2 , Lorie Brinkman  1   2 , Michael Su  1   2 , Tracy Y Chang  1   2 , Steven C Cramer  1   2
Affiliations

Wrist Proprioception in Adults with and without Subacute Stroke

Brittany M Young et al. Brain Sci. .

Abstract

Proprioception is critical to motor control and functional status but has received limited study early after stroke. Patients admitted to an inpatient rehabilitation facility for stroke (n = 18, mean(±SD) 12.5 ± 6.6 days from stroke) and older healthy controls (n = 19) completed the Wrist Position Sense Test (WPST), a validated, quantitative measure of wrist proprioception, as well as motor and cognitive testing. Patients were serially tested when available (n = 12, mean 11 days between assessments). In controls, mean(±SD) WPST error was 9.7 ± 3.5° in the dominant wrist and 8.8 ± 3.8° in the nondominant wrist (p = 0.31). In patients with stroke, WPST error was 18.6 ± 9° in the more-affected wrist, with abnormal values present in 88.2%; and 11.5 ± 5.6° in the less-affected wrist, with abnormal values present in 72.2%. Error in the more-affected wrist was higher than in the less-affected wrist (p = 0.003) or in the dominant (p = 0.001) and nondominant (p < 0.001) wrist of controls. Age and BBT performance correlated with dominant hand WPST error in controls. WPST error in either wrist after stroke was not related to age, BBT, MoCA, or Fugl-Meyer scores. WPST error did not significantly change in retested patients. Wrist proprioception deficits are common, bilateral, and persistent in subacute stroke and not explained by cognitive or motor deficits.

Keywords: neurorehabilitation; proprioception; recovery; rehabilitation; sensory; stroke.

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Conflict of interest statement

Cramer serves as a consultant for Abbvie, Constant Therapeutics, MicroTransponder, Neurolutions, Panaxium, Elevian, Medtronic, Helius, Omniscient, Brainsgate, and TRCare.

Figures

Figure 1
Figure 1
Example showing positioning of Examiner, Subject, and testing apparatus used for Wrist Position Sense Test administration. (A) Relative positioning of Examiner and Subject, with WPST Apparatus situated between them. (B) Positioning of Subject’s tested wrist within WPST apparatus, as well as non-tested upper extremity used to manipulate pointer on the top surface of WPST apparatus. (C) Relative placement of Upper and Lower Protractors. Note that the Upper Protractor obstructs the subject’s line of sight, preventing subject’s ability to view the tested wrist.
Figure 2
Figure 2
Wrist Position Sense Test Error By Subject Group And Side. Data are for Visit 1. WPST = Wrist Position Sense Test, * significant at p < 0.01 after correction for multiple comparisons, ** significant at p < 0.001 after correction for multiple comparisons, Dots represent outlier data points for respective box and whisker plots.
Figure 3
Figure 3
Correlates of dominant wrist WPST error in Control Group subjects. (A) WPST error correlates with higher age (B) WPST error correlates with Box and Blocks Test performance. WPST = Wrist Position Sense Test.
See this image and copyright information in PMC

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