Individuals with chronic hemiparetic stroke can correctly match forearm positions within a single arm

Abstract

Objective-Previous studies determined, using between arms position matching assessments, that at least one-half of individuals with stroke have an impaired position sense. We investigated whether individuals with chronic stroke who have impairments mirroring arm positions also have impairments identifying the location of each arm in space.Methods-Participants with chronic hemiparetic stroke and age-matched participants without neurological impairments (controls) performed a between forearms position matching task based on a clinical assessment and a single forearm position matching task, using passive and active movements, based on a robotic assessment.Results-12 out of our 14 participants with stroke who had clinically determined between forearms position matching impairments had greater errors than the controls in both their paretic and non-paretic arm when matching positions during passive movements; yet stroke participants performed comparable to the controls during active movements.Conclusions-Many individuals with chronic stroke may have impairments matching positions in both their paretic and non-paretic arm if their arm is moved for them, yet not within either arm if these individuals control their own movements.Significance-The neural mechanisms governing arm location perception in the stroke population may differ depending on whether arm movements are made passively versus actively.

Dynamic Information Flow Based on EEG and Diffusion MRI in Stroke: A Proof-of-Principle Study

“…There is growing evidence indicating an increased usage of ipsilateral (contralesional) cortical motor network associated with the loss of independent joint control (van Kordelaar et al, 2012 , 2013 , 2014 ) or the expression of the flexion synergy in the paretic upper limb following hemiparetic stroke (Yao et al, 2009 ; Wilkins et al, 2017 ; McPherson et al, 2018 ). However, less is known regarding changes of somatosensory cortical networks in this cohort (Gurari et al, 2017 , 2018 ; Vlaar et al, 2017 ). Our results could provide new evidence of reconfiguration of somatosensory cortical networks in individuals with hemiparetic stroke, which cannot be revealed by current clinical assessments.…”

Ability of individuals with chronic hemiparetic stroke to locate their forearms during single-arm and between-arms tasks

“…As highlighted by Daniel Goble in 2010, the choice of a single-arm task versus a between-arms task is not trivial [ 5 ]. Our 2017 article mentioned above underscores this point [ 4 ], and the work of Hirayama et al in 1999 further addresses this notion [ 6 ]. Hirayama et al showed that the ability of patients with lesions to use their non-paretic hand to detect the location of their paretic thumb in space (i.e., thumb localizing test) does not necessarily correlate with their ability to detect the direction of movement passively occurring at their paretic digits (i.e., joint position and movement sense).…”

“…A robotic system and automated protocol were used to quantify every participant’s ability to match and mirror forearm positions within each arm and between arms, respectively. A discussion of the tested participants, setup, and data collection protocol for each experiment is provided below and is presented in more detail in [ 4 ] and [ 48 ].…”

“…Our original hypothesis for why survivors of a stroke may not accurately locate their limb(s) in space was that they had deficits in locating their paretic limb, and possibly their non-paretic limb, independently. Yet, our first study revealed that an individual with chronic hemiparetic stroke who has a deficit when mirroring their forearms on a clinical between-arms task does not necessarily have a deficit when locating their paretic forearm and non-paretic forearm, separately, on a robotic single-arm position-matching task [ 4 ]. Therefore, we now hypothesize that the deficit arose due to the: i) comparison of inaccurate position information relayed from either/both arm(s) and/or ii) inaccurate processing of accurate position information that was relayed from either/both arm(s).…”

“…In this manuscript, our goal was to determine whether individuals with chronic hemiparetic stroke had deficits when matching forearm positions within a single arm and mirroring forearm positions between arms, independent of the forearm referenced. We hypothesized, based on findings in [ 4 ] and [ 6 ], that participants with chronic hemiparetic stroke who were classified as having a position-mirroring deficit, yet an intact ability to detect the direction of their arm’s movement, would: i) not have a deficit when matching forearm positions within their paretic arm and non-paretic arm, separately (single-arm experiment), and ii) have a deficit when mirroring forearm positions between arms when their non-paretic forearm mirrored their paretic forearm, yet not have a deficit when their paretic forearm mirrored their non-paretic forearm. These findings would support the notion that employing a variety of single-arm and between-arms tasks provides a more complete assessment of an individual’s ability to locate their arm(s) in space than employing only one of these tasks, which currently is the approach often taken, e.g., [ 5 , 43 – 46 ].…”