Introduction
Methods
Subjects
Robotic assessment of position sense
Arm-position matching task
Occluded vision
Normal vision
Measures of position sense
Clinical assessment
Analysis
Results
Subject characteristics
Measure | Stroke Survivors | Control Subjects | |
---|---|---|---|
Left-Affected {n = 108} | Right-Affected {n = 69} | {n = 130} | |
Age | 64 (20–89) | 62 (21–90) | 56 (20–88) |
Sex | 78 M, 30 F | 41 M, 28 F | 67 M, 63 F |
Handedness | 99 R, 4 L, 5 A | 60 R, 5 L, 4 A | 112 R, 12 L, 6 A |
Stroke type | 87 Isc, 21 Hem | 59 Isc, 10 Hem | – |
Days since stroke | 10 (1–55) | 11 (2–52) | – |
FIM | 96 (35–126) | 103 (40–126) | – |
TLT affected arm [0–3] | [9, 22, 31, 46] | [4, 10, 17, 38] | – |
BIT | 138 (51–146) | 143 (58–146) | – |
Visual field defects | 24 Y, 84 N | 8 Y, 61 N | – |
PPB affected | 3 (0–13) | 4 (0–15) | – |
PPB less affected | 10 (4–16) | 10 (5–16) | 14 (8–18) |
CMSA affected arm [1–7] | [4, 9, 11, 15, 22, 31]a | [4, 6, 10, 13, 20] | – |
CMSA affected hand [1–7] | [6, 8, 14, 18, 24, 28]b | [5, 6, 9, 11, 16, 17] | – |
CMSA less affected arm [1–7] | [0, 0, 0, 0, 4, 21, 82]a | [0, 0, 0, 0, 0, 6, 63] | – |
CMSA less affected hand [1–7] | [0, 0, 0, 0, 0, 34, 72]b | [0, 0, 0, 0, 3, 18, 48] | – |
MAS affected arm [0–4] | [77, 15, 7, 8, 0, 0]a | [52, 9, 4, 1, 1, 0]d | – |
MAS less affected arm [0–4] | [104, 3, 0, 0, 0, 0]a | [67, 0, 0, 0, 0, 0]d | – |
MoCA | 24 (13–30)c | 24 (8–29)e | – |
Subgroup | # Subjects {n = 177} | |
---|---|---|
Single Territory | MCA | 117 |
PCA | 22 | |
ACA | 6 | |
Basilar | 6 | |
Vertebral | 4 | |
Pontine | 4 | |
PICA | 3 | |
Internal Carotid | 2 | |
Anterior Choroidal | 1 | |
Multiple Territories | MCA, ACA | 5 |
MCA, PCA | 3 | |
MCA, ACA, PCA | 1 | |
Other | Unknown | 2 |
Other | 1 |
Sex | Age Range | |||||||
---|---|---|---|---|---|---|---|---|
20–29 | 30–39 | 40–49 | 50–59 | 60–69 | 70–79 | 80–89 | All Ages | |
Male | 7 | 10 | 7 | 9 | 14 | 14 | 6 | 67 |
Female | 10 | 10 | 10 | 10 | 11 | 10 | 2 | 63 |
Both | 17 | 20 | 17 | 19 | 25 | 24 | 8 | 130 |
Examining the ability to compensate for impaired position sense with vision
Exemplar subjects
Group data - Variability
Measure | Factor | Group | Subjects | Impaired with OV | Compensation with NV | ||
---|---|---|---|---|---|---|---|
Full | Partial | Absent | |||||
Var
| All subjects | 177 | 116 (66%) | 23 (20%) | 37 (32%) | 56 (48%) | |
More affected side of body | Left-affected | 108 | 87 (81%) | 13 (15%) | 29 (33%) | 45 (52%) | |
Right-affected | 69 | 29 (42%) | 10 (34%) | 8 (28%) | 11 (38%) | ||
Vascular Territory | MCA | 117 | 79 (68%) | 14 (18%) | 28 (35%) | 37 (47%) | |
PCA | 22 | 16 (73%) | 5 (31%) | 3 (19%) | 8 (50%) | ||
ACA | 6 | 2 (33%) | 0 (0%) | 1 (50%) | 1 (50%) | ||
Brainstem | 14 | 9 (64%) | 1 (11%) | 3 (33%) | 5 (56%) | ||
Cerebellar | 3 | 1 (33%) | 0 (0%) | 1 (100%) | 0 (0%) | ||
Perceptual Impairment | Spatial Neglect | 23 | 21 (91%) | 2 (10%) | 8 (38%) | 11 (52%) | |
Visual Defect | 13 | 6 (46%) | 0 (0%) | 1 (17%) | 5 (83%) | ||
Both | 19 | 19 (100%) | 1 (5%) | 5 (26%) | 13 (68%) | ||
Neither | 122 | 70 (57%) | 20 (29%) | 23 (33%) | 27 (39%) | ||
C/E
| All subjects | 177 | 91 (51%) | 42 (46%) | 8 (9%) | 41 (45%) | |
More affected side of body | Left-affected | 108 | 66 (61%) | 26 (39%) | 6 (11%) | 34 (52%) | |
Right-affected | 69 | 25 (36%) | 16 (64%) | 2 (8%) | 7 (28%) | ||
Vascular Territory | MCA | 117 | 63 (54%) | 28 (44%) | 3 (5%) | 32 (51%) | |
PCA | 22 | 16 (73%) | 10 (63%) | 2 (13%) | 4 (25%) | ||
ACA | 6 | 2 (33%) | 1 (50%) | 0 (0%) | 1 (50%) | ||
Brainstem | 14 | 1 (7%) | 0 (0%) | 0 (0%) | 1 (100%) | ||
Cerebellar | 3 | 2 (67%) | 2 (100%) | 0 (0%) | 0 (0%) | ||
Perceptual Impairment | Spatial Neglect | 23 | 20 (87%) | 3 (15%) | 2 (10%) | 15 (75%) | |
Visual Defect | 13 | 5 (38%) | 2 (40%) | 1 (20%) | 2 (40%) | ||
Both | 19 | 15 (79%) | 4 (27%) | 2 (13%) | 9 (60%) | ||
Neither | 122 | 51 (42%) | 33 (65%) | 3 (6%) | 15 (29%) | ||
Shift
| All subjects | 177 | 52 (29%) | 32 (62%) | 3 (6%) | 17 (33%) | |
More affected side of body | Left-affected | 108 | 38 (35%) | 19 (50%) | 3 (8%) | 16 (42%) | |
Right-affected | 69 | 14 (20%) | 13 (93%) | 0 (0%) | 1 (7%) | ||
Vascular Territory | MCA | 117 | 39 (33%) | 23 (59%) | 3 (8%) | 13 (33%) | |
PCA | 22 | 4 (18%) | 3 (75%) | 0 (0%) | 1 (25%) | ||
ACA | 6 | 2 (33%) | 1 (50%) | 0 (0%) | 1 (50%) | ||
Brainstem | 14 | 3 (21%) | 3 (100%) | 0 (0%) | 0 (0%) | ||
Cerebellar | 3 | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) | ||
Perceptual Impairment | Spatial Neglect | 23 | 11 (48%) | 5 (45%) | 0 (0%) | 6 (55%) | |
Visual Defect | 13 | 3 (23%) | 0 (0%) | 1 (33%) | 2 (67%) | ||
Both | 19 | 11 (58%) | 6 (55%) | 1 (9%) | 4 (36%) | ||
Neither | 122 | 27 (22%) | 21 (78%) | 1 (4%) | 5 (19%) |
Group data - Contraction/Expansion
Group data - Shift
Relationships of stroke features and perceptual impairments with compensation
Examining the impact of body side affected and stroke location
Examining the impact of perceptual impairments
Clinical Measure | Improvement | Occluded Vision | Normal Vision | ||||||
---|---|---|---|---|---|---|---|---|---|
Var (n = 116) | C/E (n = 91) | Shift (n = 52) | Var (n = 116) | C/E (n = 91) | Shift (n = 52) | Var (n = 116) | C/E (n = 91) | Shift (n = 52) | |
FIM | −0.05 * | −0.04 * | −0.11 * | −0.37 ‡ | −0.34 † | −0.20 * | −0.36 ‡ | −0.18 * | −0.07 * |
BIT | −0.16 * | −0.32 ‡ | −0.19 * | −0.46 § | −0.32 † | −0.07 * | −0.63 § | −0.45 ‡ | −0.34 † |
PPB more affected | −0.20 * | −0.17 * | −0.08 * | −0.01 * | −0.25 † | −0.05 * | −0.17 * | −0.28 † | −0.03 * |
PPB less affected | −0.02 * | −0.02 * | −0.14 * | −0.33 ‡ | −0.37 ‡ | −0.21 * | −0.30 ‡ | −0.14 * | −0.02 * |
MoCA | −0.09 * | −0.29 † | −0.21 * | −0.16 * | −0.18 * | −0.04 * | −0.29 † | −0.33 † | −0.27 * |