Neural Correlates of Passive Position Finger Sense After Stroke.
Morgan L Ingemanson, Justin R Rowe, Vicky Chan and 4 others
PMID 31319755WHAT IT FOUND
Robotic testing found finger proprioception deficits in 67% of stroke survivors' contralesional hands, far exceeding the 26% detected by standard clinical scales.
Deficits were best explained by combined sensory system injury and functional connectivity, not motor damage alone.
Key findings
01Robot-assessed finger proprioception deficits were present in 67% of contralesional hands and 63% of ipsilesional hands, whereas the Fugl-Meyer sensory scale detected contralesional impairment in only 26% and ipsilesional impairment in 0%.
02A multivariable model combining total sensory system injury and ipsilesional M1-S2 functional connectivity explained 63% of variance in contralesional proprioception error, outperforming any single measure.
03Robotic proprioception error correlated with clinical sensory assessments but not with motor, language, attention, or depression scores, indicating specificity to sensory function.
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 used a novel robotic device not yet widely available in clinical settings. Proprioception testing required a key press with the less impaired hand, which could introduce motor or reaction time confounds, though authors argue this was minimal. Five subjects were excluded from white matter analysis due to lesion location, and two from MRI due to claustrophobia, reducing the sample for neural correlate analyses. The study is cross-sectional and does not determine if the identified neural correlates are causal or merely associated with deficits. The control group data was from a previously published normative study, not collected concurrently in the same cohort.
Declared interests
Dr. Reinkensmeyer is a co-founder of Flint Rehabilitation Devices and holds equity in Hocoma (rehab technology manufacturers). Dr. Rowe is employed by Flint Rehabilitation Devices. Dr. Cramer has consulted for multiple pharmaceutical and device companies. Funding was from NIH.
The easy way to misread this
Do not interpret the 67% deficit rate as evidence that this specific robotic device is now the clinical standard. It is a research tool that reveals deficits often missed by bedside tests, but its availability and utility in routine practice are not yet established. Also, the study does not show that treating proprioception improves function, only that deficits are common and linked to specific neural factors.