Young Brittany M, Yadav Rishika, Rana Shivam, Kim Won-Seok, Liu Camellia, Batth Rajan, Sakthi Shivani, Farahmand Eden, Han Simon, Patel Darshan, Luo Jason, Ramsey Christina, Feldman Marc, Cardoso-Ferreira Isabel, Holl Christina, Nguyen Tiffany, Brinkman Lorie, Su Michael, Chang Tracy Y, Cramer Steven C
Department of Neurology, University of California, 710 Westwood Plaza, Los Angeles, CA 90095, USA.
California Rehabilitation Institute, 2070 Century Park East Rm 117, Los Angeles, CA 90067, USA.
Brain Sci. 2022 Dec 23;13(1):31. doi: 10.3390/brainsci13010031.
Proprioception is critical to motor control and functional status but has received limited study early after stroke. Patients admitted to an inpatient rehabilitation facility for stroke (n = 18, mean(±SD) 12.5 ± 6.6 days from stroke) and older healthy controls (n = 19) completed the Wrist Position Sense Test (WPST), a validated, quantitative measure of wrist proprioception, as well as motor and cognitive testing. Patients were serially tested when available (n = 12, mean 11 days between assessments). In controls, mean(±SD) WPST error was 9.7 ± 3.5° in the dominant wrist and 8.8 ± 3.8° in the nondominant wrist (p = 0.31). In patients with stroke, WPST error was 18.6 ± 9° in the more-affected wrist, with abnormal values present in 88.2%; and 11.5 ± 5.6° in the less-affected wrist, with abnormal values present in 72.2%. Error in the more-affected wrist was higher than in the less-affected wrist (p = 0.003) or in the dominant (p = 0.001) and nondominant (p < 0.001) wrist of controls. Age and BBT performance correlated with dominant hand WPST error in controls. WPST error in either wrist after stroke was not related to age, BBT, MoCA, or Fugl-Meyer scores. WPST error did not significantly change in retested patients. Wrist proprioception deficits are common, bilateral, and persistent in subacute stroke and not explained by cognitive or motor deficits.
本体感觉对运动控制和功能状态至关重要，但在中风后的早期阶段，相关研究有限。入住住院康复机构的中风患者（n = 18，中风后平均（±标准差）12.5 ± 6.6天）和老年健康对照者（n = 19）完成了腕关节位置觉测试（WPST），这是一种经过验证的、用于定量测量腕关节本体感觉的方法，同时还进行了运动和认知测试。患者在可行时进行了系列测试（n = 12，两次评估之间的平均间隔为11天）。在对照组中，优势腕的平均（±标准差）WPST误差为9.7 ± 3.5°，非优势腕为8.8 ± 3.8°（p = 0.31）。在中风患者中，受影响较重的腕关节WPST误差为18.6 ± 9°，88.2%的患者值异常；受影响较轻的腕关节为11.5 ± 5.6°，72.2%的患者值异常。受影响较重的腕关节的误差高于受影响较轻的腕关节（p = 0.003），也高于对照组优势腕（p = 0.001）和非优势腕（p < 0.001）的误差。在对照组中，年龄和箱-块测试（BBT）表现与优势手的WPST误差相关。中风后任一腕关节的WPST误差与年龄、BBT、蒙特利尔认知评估量表（MoCA）或Fugl-Meyer评分均无关。再次测试的患者中，WPST误差没有显著变化。腕关节本体感觉缺陷在亚急性中风中很常见，是双侧性且持续存在的，不能用认知或运动缺陷来解释。
