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

Abstract

Introduction: Proprioceptive impairment is a common symptom after stroke. Clarifying how proprioception correlates with motor function after stroke may be helpful in optimizing proprioception-augmented movement training. Previous studies have shown inconsistent findings. A meta-analysis is an optimal method to explore the correlation and identify the factors contributing to these inconsistencies.Objective: To explore the correlation between proprioception and motor function after stroke through a meta-analysis, taking into account characteristics of the measurements used in these studies.Methods: We searched multiple databases until November 2021 for eligible studies that measured both proprioception and motor functions in persons with stroke and reported their correlation or data for correlation analysis. A meta-analysis of the correlations was performed. The subgroup analysis and meta-regression were further conducted to investigate potential factors contributing to the heterogeneity of correlation strength, based on the participants' characteristics, proprioception, and motor function measures.Results: In total, 28 studies comprising of 1,829 participants with stroke were included in the meta-analysis. The overall correlation between proprioception and motor function was significant (r = 0.267, p < 0.05), but there was heterogeneity across studies (I2 = 45%, p < 0.05). The results of the subgroup analysis showed proprioception of the axial segment in weight-bearing conditions (r = 0.443, p < 0.05) and upper limb without weight-bearing (r = 0.292, p < 0.05) had a stronger correlation with motor function than proprioception of the lower limb without weight-bearing. The proprioception measured through ipsilateral matching (r = 0.412, p < 0.05) showed a stronger correlation with motor function than through contralateral matching. The International Classification of Functioning, Disability, and Health (ICF) domains of motor function, movement function (r = 0.338, p < 0.05), activity performance (r = 0.239, p < 0.05), and independence (r = 0.319, p < 0.05) showed a stronger correlation with proprioception than with other domains.Conclusion: There is a significant correlation between proprioception and motor dysfunction after stroke. The proprioception measured in the axial segment under weight-bearing conditions or measured with ipsilateral matching, and motor function, specifically in the ICF domains of movement function, activity performance, and independence showed a positive contribution to the association between proprioception and motor function. The correlation does not imply causation and might be underestimated by attributes of current tests for proprioception and motor function. Further studies are needed to clarify the cause-effect relationship.

Effect of Whole-Body Vibration Exercise on Pain, Disability, Balance, Proprioception, Functional Performance and Quality of Life in People with Non-Specific Chronic Low Back Pain: A Systematic Review and Meta-Analysis

“…Furthermore, WBVE has been shown to improve proprioceptive feedback, which is crucial for maintaining balance and stability during movement [ 60 ]. Enhanced proprioception can lead to improved motor control and reduced risk of falls and injuries, contributing to decreased disability scores [ 61 , 62 ].…”

Can We Target Close Therapeutic Goals in the Gait Re-Education Algorithm for Stroke Patients at the Beginning of the Rehabilitation Process?

“…Knee proprioception plays a key role in maintaining the joint stability and coordination during movement [ 30 ]. Due to the occurrence of proprioception deficits in a large group of people after a stroke (approximately 50–60% of stroke survivors) and their association with mobility and balance disorders, our set of tests included the assessment of one of the proprioception components, which is joint position sense [ 31 , 32 , 33 ]. The patients’ task during the JPS test was similar to the studies conducted by Imanawanto et al [ 34 ] and Hwang et al [ 35 ], restoring the position of 30° of knee flexion and then the position of 60° of knee flexion.…”

Influence of the constraint-induced method of constraint-induced movement therapy on improving lower limb outcomes after stroke: A meta-analysis review

“…Our study did not differentiate balance ability measured by using the BBS from functional mobility measured by the walking test, considering that BBS is an instrument used to evaluate functional mobility on sitting, standing, and positional or postural transfer, and it correlates with gait velocity ( 31 ). We categorized outcomes based on the ICF framework, a widely used method in meta-analysis studies, ensuring that more studies are included in subgroup meta-analyses ( 4 , 24 ). Unlike previous reviews, our study discovered that CIMT had superior short-term effects on activity performance, movement function, and participation than the conventional treatment.…”

“…Meta-analyses were conducted across all studies of the same design first. Only one outcome measure of each study was included in each meta-analysis, which appeared most frequently in included studies of the corresponding meta-analysis ( 24 , 25 ). Considering ICF categories of outcome measures showing significant contributions to the effect sizes found in the present study (reported in the section Results), meta-analyses across studies with the same design but grouped based on ICF categories of outcome measures were further conducted.…”