Vision does not always help stroke survivors compensate for impaired limb position sense.
Troy M Herter, Stephen H Scott, Sean P Dukelow
PMID 31666135WHAT IT FOUND
Vision does not reliably help stroke survivors with impaired limb position sense.
While some fully compensated, many showed only partial or no improvement. This challenges the common assumption that watching the affected limb solves proprioceptive deficits.
Key findings
01For the measure of movement variability, 48% of stroke survivors showed no improvement with vision, and only 20% fully compensated.
02Stroke survivors with left-sided body weakness were significantly more likely to show impaired position sense and less likely to fully compensate with vision than those with right-sided weakness.
03The ability to use vision to improve position sense was not associated with greater functional independence scores.
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 only examined position sense in the proximal upper limb (shoulder and elbow) in a horizontal plane, so results may not apply to hand/finger control or lower limb movement. Participants were recruited during sub-acute inpatient rehabilitation; compensation abilities might change in the chronic phase. The study was cross-sectional, so it cannot prove that the ability to use vision causes better functional outcomes, only that they are associated. Some clinical assessments were missing for a subset of participants.
Declared interests
Funding was provided by the Canadian Institutes of Health Research, the Heart and Stroke Foundation of Canada, and the Ontario Research Fund. The authors declared no competing interests.
The easy way to misread this
Do not conclude that vision is useless for all patients. A significant minority (20% for variability, 46% for spatial area) did fully compensate. The finding is that vision does not *reliably* or *universally* compensate for impaired position sense, and it should not be assumed to work without testing.