Wrist Proprioception in Acute and Subacute Stroke: A Robotic Protocol for Highly Impaired Patients

Abstract

Proprioception is a critical component of sensorimotor functions which directly affect recovery after neurological injuries. However, clinical tests of proprioception still lack sensitivity and reliability, while robotic devices can provide quantitative, accurate, and repeatable metrics. This work presents the analysis of the efficacy of a robotic assessment of wrist proprioception in terms of the capability to discern between movements along the different DoFs in a healthy population with a broad range of age. The effect of aging on the proprioceptive matching was analyzed to select an appropriate control group for the comparison with stroke patients, designed to confirm the hypothesis that a high percentage of stroke patients presents proprioceptive impairments in the acute and subacute states. Results show that the protocol is capable of detecting differences in performance along different movement directions, and that wrist proprioception does not deteriorate in the age ranges analyzed. Finally, stroke patients were less accurate in matching the position of their wrist, confirming the hypothesis that proprioceptive performance is often impaired in the acute and subacute phases of stroke.