Does Upper Extremity Proprioceptive Training Have an Impact on Functional Outcomes in Chronic Stroke Patients?

We aimed to investigate the effect of upper extremity proprioceptive training on spasticity and functional motor skills in patients with chronic hemiplegia occurring after stroke.

Thirty chronic hemiplegic patients (17 females, mean age: 66.47±12.55 years) admitted to the Research Center with a diagnosis of chronic hemiplegia developed after stroke were included in the study. Patients were divided into two groups. The first group received a conventional physiotherapy program (PTR) for 5 days a week and the second group additionally received a proprioceptive training program (PTR-PT) for 5 days a week. Before and 6 weeks after the treatment modified Ashworth scale (MAS), Fugl-Meyer upper extremity motor evaluation scale (FMA) and action-research-arm-test (ARAT) and motor activity log-28 scale (MAL-28) were applied. SSPS-22.0 program was used for statistical evaluation and p <0.05 was considered as the level of statistical significance.

There was no difference in MAS scores before and after treatment in the groups (p>0.05). There was a statistically significant improvement in both PTR (p<0.05) and PTR-PT groups (p<0.001) for the FMA, ARAT and MAL-28. scale scores. Although the results obtained in the PTR, and PT groups were more improved, there was a significant result in favor of PTR-PT only regarding the MAL-28 scale scores (p<0.05). It was determined that adding proprioception-based exercises had the greatest effect on FMA, ARAT and MAL-28 in the evaluation of the effect size (>0.3).

It was observed that upper extremity proprioceptive training yielded better results in patients with chronic hemiplegia developed after stroke than conventional therapy in increasing the frequency and quality of movement in upper extremity. This result shows that proprioceptive training programs should be added to stroke rehabilitation methods.