Related Experiment Video
Updated: Nov 5, 2025
The Impact of Motor Task Conditions on Goal-Directed Arm Reaching Kinematics and Trunk Compensation in Chronic Stroke Survivors
Published on: May 2, 2021
Relative independence of upper limb position sense and reaching in children with hemiparetic perinatal stroke
Andrea M Kuczynski1,2, Adam Kirton3,4,5, Jennifer A Semrau5,6
1University of Calgary, 1403 29th St. NW, Foothills Medical Centre, Calgary, AB, T2N 0P8, Canada. spdukelo@ucalgary.ca.
Insights
This study found that robotic assessments show position sense and reaching deficits in children with perinatal stroke are largely independent. These findings may guide future rehabilitation strategies for hemiparetic cerebral palsy.
Area of Science:
- Neurology
- Pediatrics
- Rehabilitation Medicine
Background:
- Proprioceptive dysfunction is linked to upper extremity motor impairment in adult stroke survivors.
- This study investigates the relationship between position sense and reaching in children with perinatal stroke using robotic technology.
Purpose of the Study:
- To assess the relationship between upper limb position sense and reaching abilities in children with perinatal stroke.
- To compare robotic measures of sensory and motor function with clinical assessments.
Main Methods:
- Recruited children with perinatal stroke and neurotypical controls.
- Utilized the Kinarm robot for arm position-matching and visually guided reaching tasks.
- Administered clinical assessments for sensory and motor function.
Main Results:
- Position sense and reaching performance in children with stroke did not significantly correlate.
- Robotic sensory and motor measures showed modest correlations with some clinical tests.
- Assisting Hand Assessment scores correlated with reaction time, initial direction error, and movement time in reaching tasks.
Conclusions:
- Robotic technology effectively quantifies upper limb sensory and motor function in hemiparetic children.
- Deficits in position sense and reaching appear independent in these children.
- Understanding these relationships can inform rehabilitation strategies for hemiparetic cerebral palsy.
Background:
Studies using clinical measures have suggested that proprioceptive dysfunction is related to motor impairment of the upper extremity following adult stroke. We used robotic technology and clinical measures to assess the relationship between position sense and reaching with the hemiparetic upper limb in children with perinatal stroke.
Methods:
Prospective term-born children with magnetic resonance imaging-confirmed perinatal ischemic stroke and upper extremity deficits were recruited from a population-based cohort. Neurotypical controls were recruited from the community. Participants completed two tasks in the Kinarm robot: arm position-matching (three parameters: variability [Varxy], contraction/expansion [Areaxy], systematic spatial shift [Shiftxy]) and visually guided reaching (five parameters: posture speed [PS], reaction time [RT], initial direction error [IDE], speed maxima count [SMC], movement time [MT]). Additional clinical assessments of sensory (thumb localization test) and motor impairment (Assisting Hand Assessment, Chedoke-McMaster Stroke Assessment) were completed and compared to robotic measures.
Results:
Forty-eight children with stroke (26 arterial, 22 venous, mean age: 12.0 ± 4.0 years) and 145 controls (mean age: 12.8 ± 3.9 years) completed both tasks. Position-matching performance in children with stroke did not correlate with performance on the visually guided reaching task. Robotic sensory and motor measures correlated with only some clinical tests. For example, AHA scores correlated with reaction time (R = - 0.61, p < 0.001), initial direction error (R = - 0.64, p < 0.001), and movement time (R = - 0.62, p < 0.001).
Conclusions:
Robotic technology can quantify complex, discrete aspects of upper limb sensory and motor function in hemiparetic children. Robot-measured deficits in position sense and reaching with the contralesional limb appear to be relatively independent of each other and correlations for both with clinical measures are modest. Knowledge of the relationship between sensory and motor impairment may inform future rehabilitation strategies and improve outcomes for children with hemiparetic cerebral palsy.
