Movement kinematics and proprioception in post-stroke spasticity: assessment using the Kinarm robotic exoskeleton.
George Mochizuki, Andrew Centen, Myles Resnick and 3 others
PMID 31753011WHAT IT FOUND
Stroke patients with spasticity showed slower and less smooth reaching than those without, but proprioception deficits were similar between groups.
Both groups struggled with position matching compared to healthy norms. Assess timing and speed separately from sensory function.
Key findings
01Individuals with spasticity had significantly greater deficits in movement time and maximum speed during reaching tasks compared to those without spasticity.
02There were no significant differences in proprioception measures (arm position matching) between stroke patients with and without spasticity.
03A higher proportion of individuals with spasticity failed the overall motor task score compared to those without spasticity.
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 study did not measure muscle strength, which is a known confounder in spasticity and motor output. Only position sense (a component of proprioception) was assessed; kinesthesia and sense of effort were not measured. Spasticity was assessed using only the Modified Ashworth Scale, which has known limitations. Some participants in the no-spasticity group may have had undetected extensor spasticity, potentially masking group differences. The groups differed significantly in time since stroke (median 6.28 months vs 14.73 months) and medication use, though statistical comparisons of these factors showed no impact on the primary kinematic outcomes.
Declared interests
The study was funded by the FedDev Technology Development Program for Southern Ontario and the Ontario Research Foundation. The Kinarm robotic exoskeleton is a commercial product; the authors' relationship with the manufacturer is not explicitly detailed beyond the use of its software and normative data.
The easy way to misread this
Do not conclude that spasticity causes proprioceptive deficits. The study found that proprioceptive impairment was present in all stroke patients regardless of spasticity status, and did not differ between the two groups. The specific impact of spasticity was on motor speed and timing.