Xu Jinyao, Witchalls Jeremy, Preston Elisabeth, Pan Li, Zhang Gengyuan, Waddington Gordon, Adams Roger, Han Jia
Research Institute for Sport and Exercise, University of Canberra, Canberra, Australia.
Faculty of Health, University of Canberra, Canberra, Australia.
Physiother Res Int. 2025 Jan;30(1):e70027. doi: 10.1002/pri.70027.
Proprioceptive deficits are common among stroke survivors and can negatively impact their balance and postural control. However, there has been little evaluation of the change in proprioceptive deficits in the lower limbs over time after stroke. This study aimed to examine proprioceptive deficits over time after stroke in both the affected and "unaffected" lower limbs.
This cross-sectional study included sixty first-time unilateral stroke survivors and twenty age-matched healthy individuals. Participants after stroke were divided into three subgroups based on different time points after stroke. The generally accepted clinical time points after stroke are the first 4 weeks-the acute stage; 5-24 weeks-the subacute stage; over 24 weeks-the chronic stage. The active movement extent discrimination apparatus (AMEDA) was used to quantify ankle proprioception in plantarflexion and inversion directions, on both the affected and "unaffected" sides.
Lower limb proprioception scores decreased linearly over time after stroke on both the affected and "unaffected" sides (p < 0.001). Overall, proprioception scores for the stroke groups were significantly lower than those for the healthy age-matched group (p < 0.01), with the only exception being ankle plantarflexion and inversion scores on the unaffected side in the acute stroke group, which were not significantly different from their healthy counterparts.
Ankle proprioception in both lower limbs decreased over time after a unilateral stroke, with proprioceptive acuity on the "unaffected" side diminishing linearly in the same way as that on the affected side. These observed continuing deficits in lower limb proprioception among stroke survivors raise implications for clinical neurorehabilitation.
本体感觉缺陷在中风幸存者中很常见,并且会对他们的平衡和姿势控制产生负面影响。然而,对于中风后下肢本体感觉缺陷随时间的变化评估较少。本研究旨在探讨中风后受累和“未受累”下肢的本体感觉缺陷随时间的变化情况。
这项横断面研究纳入了60名首次发生单侧中风的幸存者和20名年龄匹配的健康个体。中风后的参与者根据中风后的不同时间点分为三个亚组。中风后普遍接受的临床时间点为:前4周——急性期;5 - 24周——亚急性期;超过24周——慢性期。使用主动运动范围辨别仪(AMEDA)对受累侧和“未受累”侧踝关节在跖屈和内翻方向的本体感觉进行量化。
中风后,受累侧和“未受累”侧下肢的本体感觉评分均随时间呈线性下降(p < 0.001)。总体而言,中风组的本体感觉评分显著低于年龄匹配的健康组(p < 0.01),唯一的例外是急性中风组未受累侧的踝关节跖屈和内翻评分与健康对照组无显著差异。
单侧中风后,双下肢的踝关节本体感觉随时间下降,“未受累”侧的本体感觉敏锐度与受累侧一样呈线性下降。中风幸存者下肢本体感觉持续存在这些缺陷,对临床神经康复具有启示意义。