The Brief Kinesthesia test is feasible and sensitive: a study in stroke

Abstract

BACKGROUND: Clinicians lack a quantitative measure of kinesthetic sense, an important contributor to sensorimotor control of the hand and arm.OBJECTIVES: The objective here was to determine the feasibility of administering the Brief Kinesthesia Test (BKT) and begin to validate it by 1) reporting BKT scores from persons with chronic stroke and a healthy comparison group and 2) examining the relationship between the BKT scores and other valid sensory and motor measures.METHOD: Adults with stroke and mild to moderate hemiparesis (N=12) and an age-, gender-, and handedness-matched healthy comparison group (N=12) completed the BKT by reproducing three targeted reaching movements per hand with vision occluded.OTHER MEASURES: the Hand Active Sensation Test (HASTe), Touch-Test(tm) monofilament aesthesiometer, 6-item Wolf Motor Function Test (Wolf), the Motor Activity Log (MAL), and the Box and Blocks Test (BBT). A paired t-test compared BKT scores between groups. Pearson product-moment correlation coefficients assessed the relationship between BKT scores and other measures.RESULTS: Post-stroke participants performed more poorly on the BKT than comparison participants with their contralesional and ipsilesional upper extremity. The mean difference for the contralesional upper extremity was 3.7 cm (SE=1.1, t=3.34; p<0.008). The BKT score for the contralesional limb was strongly correlated with the MAL-how much (r=0.84, p=0.001), the MAL-how well (r=0.76, p=0.007), Wolf (r=0.69, p=0.02), and the BBT (r=0.77, p=0.006).CONCLUSIONS: The BKT was feasible to administer and sensitive to differences in reaching accuracy between persons with stroke and a comparison group. With further refinement, The BKT may become a valuable clinical measure of post-stroke kinesthetic impairment.

In-Home Delivery of Constraint-Induced Movement Therapy via Virtual Reality Gaming

“…39 A cut point of >6.5 cm error was used to indicate impairment in kinesthetic sense. A Touch-Test ™ monofilament esthesiometer quantifies the threshold of index finger touch perception in grams 40 with acceptable interrater reliability (intraclass correlation coefficient [ICC]: 0.77-0.99) 41 and test-retest reliability (ICC: 0.69-0.71).…”

Gross motor ability predicts response to upper extremity rehabilitation in chronic stroke

“…As in George et al (2017), the WMFT scores, recorded in seconds, were natural-log-transformed to account for the non-uniform interpretation of performance time improvement (i.e., an improvement from 5s to 3s is greater than an improvement from 105 to 103s). The BKT is a measure of error in guided reaching with visual occlusion considered to represent upper limb kinesthetic sense (Borstad and Nichols-Larsen, 2016). TM is sensitive to tactile impairment; it identifies the lightest force in grams perceived consistently by an individual on the index finger (Callahan et al 1995).…”

Correlation Between Proprioceptive Impairment and Motor Deficits After Stroke: A Meta-Analysis Review

“…Proprioception: subtypes Position sense TLT (8,9,11,15,24,25), JPS_shoulder (26), JPS_MCP (12,27), JPS_trunk (28,29), JPS_ankle (13,30,31), JPS_knee (13,32), Stand-vision perturbed (10), Reach matching task (33), Arm push matching task (14), Target reaching task (22), Arm position test (24,34), Hand position matching task (35) Motion sense Arm movement mirror-matching (11) Position and motion sense SIAS_Position_toe (36), rNSA-Proprioception (19,37,38), Elbow match task (21), FMA-UL_proprioception (20), Em-NSA_proprioception (8), JPS_ankle/knee/hip (39) 2. Proprioception: body parts Axial segment in weight-bearing conditions Stand-vision perturbed (10), JPS_trunk (28,29) Upper limbs without weight-bearing TLT (8,9,11,15,24,25), JPS_MCP (12,27), Arm push matching task ( 14), Arm movement mirror-matching (11), FMA-UL_proprioception (20), Elbow match task (21), Target reaching task (22), Arm position test …”

“…Stand-vision perturbed (10), JPS_trunk (28,29), Target reaching task (22), Arm push matching task ( 14), Reach matching task (33), JPS_MCP (27) Frontiers in Neurology | www.frontiersin.org their frequency presented across the included studies, was used to select the most common measure of proprioception or motor function for meta-analysis to minimize the heterogeneity across studies. The correlation between proprioception and motor function in patients with stroke was analyzed.…”

“…Half of the studies measured proprioception within a single joint plane, such as using the JPS test (8, 12, 13, 19-21, 26, 30-32, 36, 38, 39), while the other half assessed proprioception of multiple joint plane using methods, such as the TLT (9-11, 14, 15, 22, 24, 25, 28, 29, 33-35). Half of the studies used proprioception instruments with continuous data in the results (10,13,14,21,22,(26)(27)(28)(29)(30)(31)(32)(33)(34)(35). The other half adopted clinical tests with ordinal or categorical data in the results, such as the TLT and proprioception part of the rNSA (Tables 2, 3) (8,9,11,12,15,19,20,24,25,(36)(37)(38)(39).…”