A Tablet-Based Tool for Accurate Measurement of Hand Proprioception After Stroke

Area of Science:

• Neurorehabilitation
• Biomechanics
• Clinical Measurement

Background:

• Proprioceptive deficits in the hand are common after stroke.
• Existing clinical methods lack precision for detecting subtle hand proprioception impairments.
• There is a need for more sensitive and reliable measurement tools.

Purpose of the Study:

• To develop and evaluate a novel tablet-based tool for measuring static hand proprioception.
• To compare the performance of the tablet tool against a custom passive movement direction discrimination test (PMDD) and manual assessment.

Main Methods:

• A tablet-based adaptive staircase procedure was used to measure static hand proprioception.
• 16 individuals with chronic stroke and age-matched controls participated.
• Proprioception was assessed at the index finger's metacarpophalangeal joint using the tablet, PMDD, and Fugl-Meyer (F-M) assessment.

Main Results:

• The tablet-based measure and PMDD detected significantly impaired proprioception in stroke survivors compared to controls and their unaffected hand.
• Manual assessment (F-M) failed to detect these impairments.
• The tablet and PMDD identified deficits in 56%–75% of patients, while F-M identified only 29%.

Conclusions:

• The tablet-based tool and PMDD are more sensitive than manual assessment for detecting hand proprioception deficits post-stroke.
• The tablet tool is versatile, suitable for all impairment levels, and potentially reduces testing time.
• The tablet tool may be preferable due to its lack of ceiling effects and applicability in cases of pain or spasticity.