Robot-aided assessment and associated brain lesions of impaired ankle proprioception in chronic stroke.
Qiyin Huang, Naveen Elangovan, Mingming Zhang and 2 others
PMID 38915064WHAT IT FOUND
Most adults with chronic stroke showed impaired ankle position and motion sense on robotic testing.
These deficits were linked to lesions in the insula and temporoparietal regions. Standard clinical scales may miss these subtle proprioceptive losses that affect balance.
Key findings
0183% of adults with chronic stroke exhibited impaired ankle position or motion sense, with deficits in both submodalities seen in 50% of the group.
02Stroke survivors had significantly higher just-noticeable-difference thresholds for ankle position sense (+77%) and motion sense (+153%) compared to neurotypical controls.
03Lesions in the insula, frontal orbital, and central opercular cortex were shared by all seven stroke participants classified as having impaired proprioception.
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 included only twelve adults with chronic stroke, which limits the generalizability of the findings and the precision of lesion mapping. Participants with severe or complete somatosensory loss were excluded, so the results may underestimate the true prevalence of proprioceptive impairment in the broader stroke population. Brain lesions were mapped from acute-phase MRI scans, while proprioceptive testing occurred in the chronic phase (1-12 years post-stroke), meaning the relationship between specific lesion locations and chronic deficits is indirect. The study was not a randomized controlled trial and cannot establish causality between lesion location and proprioceptive impairment.
Declared interests
The authors declared no conflicts of interest. Funding was provided by the National Natural Science Foundation of China and the University of Minnesota.
The easy way to misread this
Do not assume that the high prevalence of proprioceptive deficits (83%) applies to all stroke survivors. The study excluded patients with severe somatosensory loss and those with markedly increased muscle tone, so the findings may not represent the most impaired or spastic patients seen in clinical practice.