Proprioception after Stroke

November 2019: Semrau et al (In Press) Differential loss of position sense and kinesthesia in sub-acute stroke. Cortex, https://doi.org/10.1016/j.cortex.2019.09.013 https://www.sciencedirect.com/science/article/pii/S0010945219303351

Humble opinion: Its relatively rare to see evidence published relating to position sense and kinesthesia, so this is an article worth reviewing, especially, because these investigators found that more than half of all those recovering from stroke had deficits in both! This places these at far higher clinical significance, than perhaps has been previously appreciated. All 285 participants in this study had recent, first-ever strokes. The methods, measures, tasks and data analyses all point towards a study that has high scientific integrity. Therefore, these findings can be trusted, giving us true, valid and reliable findings. Interestingly, the study recruited many more participants who were male, but the average age of 61 is reflective of a relatively “normal” stroke cohort.

As I inferred before, to find that more than half of people diagnosed with a recent, first-ever stroke experience deficits in position sense and kinesthesia, means that we should certainly be screening for this in all acute stroke patients, because, this is not an easily-observable deficit. What the investigators also found was that most patients with both deficits were diagnosed with right hemispheric lesions in both cortical and sub-cortical regions; so, at the very least, this sub-cohort of patient should be screened. It’s also worth keeping in mind that 22% of participants experienced only one of these deficits; and this was more likely to occur in those with smaller lesions. Unsurprisingly, the findings indicate the two deficits share common neural pathways. The other significant finding is that yes, these deficits do adversely impact a person’s ability to undertake everyday tasks. I suggest this is a very important article to read, but as always, this is just my humble opinion.

To read the abstract, select Journal Club 2019 and Proprioception after Stroke.