Kinesthetic deficits after perinatal stroke: robotic measurement in hemiparetic children.
Andrea M Kuczynski, Jennifer A Semrau, Adam Kirton and 1 others
PMID 28202036WHAT IT FOUND
Children with hemiparetic CP from perinatal stroke have measurable kinesthetic deficits.
Arterial strokes caused more severe impairments than venous ones. Vision did not compensate for these deficits. Clinical sensory exams often missed the robotic deficits.
Key findings
01Children with perinatal stroke had significantly slower response latencies and larger direction errors than healthy controls.
02Kinesthetic deficits were more common and severe in arterial ischemic stroke cases compared to periventricular venous infarction cases.
03Restoring vision did not improve kinesthetic performance in the stroke groups.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The robotic task requires intact motor function in the unaffected arm, which may exclude patients with bilateral deficits. Clinical sensory tests showed poor correlation with robotic measures, making it difficult to replace expensive robotics with bedside exams. The study is cross-sectional, so it cannot determine if these deficits change over time or with specific interventions.
Declared interests
Funding was provided by the Alberta Children's Hospital Foundation, Alberta Innovates - Health Solutions, Hotchkiss Brain Institute, and Cerebral Palsy International Research Foundation.
The easy way to misread this
Do not assume that clinical bedside sensory exams are sufficient to rule out kinesthetic deficits. The robotic measures identified impairments that often did not correlate with the clinical tests, and vision restoration did not fix the movement errors in the stroke groups.