Xu Jinyao, Witchalls Jeremy, Preston Elisabeth, Pan Li, Zhang Gengyuan, Waddington Gordon, Adams Roger David, Han Jia
Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia.
Faculty of Health, University of Canberra, Canberra, ACT, Australia.
Front Neurol. 2025 Jan 6;15:1407297. doi: 10.3389/fneur.2024.1407297. eCollection 2024.
Despite the importance of lower limb sensation in walking highlighted in systematic reviews, there is limited research investigating the effect of proprioceptive deficits after stroke and any relationship with walking ability.
With stroke survivors of different walking ability, this study aimed to (1) explore side (affected/unaffected) and movement direction (inversion/plantar flexion) effects in ankle joint position sense (JPS) acuity, and (2) compare ankle JPS acuity between groups of stroke survivors with different walking ability.
Seventy subacute stroke survivors were recruited and divided into three groups based on walking ability, as determined by their gait speed on the 10-Meter Walking Test: household (<0.4 m/s), limited community (0.4-0.8 m/s) and community (>0.8 m/s). Ankle JPS acuity was measured by the active movement extent discrimination apparatus (AMEDA).
A significant difference was found between sides, with the AMEDA scores for the unaffected side significantly higher than for the affected side (F = 22.508, < 0.001). The mean AMEDA scores for plantar flexion were significantly higher than for inversion (F = 21.366, < 0.001). There was a significant linear increase in ankle JPS acuity with increasing walking ability among stroke survivors (F = 17.802, < 0.001).
After stroke, ankle JPS acuity on the affected side was lower than the unaffected side. Stroke survivors had higher ankle JPS acuity in plantar-flexion movements, compared with inversion movements. Overall, stroke survivors with higher ankle JPS acuity tended to have higher walking ability, highlighting the importance of ankle JPS acuity in walking ability after stroke. These findings provide new insights into proprioceptive deficits after stroke and their relevance in neurorehabilitation.
尽管系统评价强调了下肢感觉在步行中的重要性，但关于中风后本体感觉缺陷的影响以及与步行能力的任何关系的研究有限。
针对不同步行能力的中风幸存者，本研究旨在（1）探讨踝关节位置觉（JPS）敏锐度的侧别（患侧/健侧）和运动方向（内翻/跖屈）效应，以及（2）比较不同步行能力的中风幸存者组之间的踝关节JPS敏锐度。
招募了70名亚急性中风幸存者，并根据他们在10米步行测试中的步态速度确定的步行能力分为三组：居家组（<0.4米/秒）、社区受限组（0.4 - 0.8米/秒）和社区组（>0.8米/秒）。通过主动运动范围辨别仪（AMEDA）测量踝关节JPS敏锐度。
发现两侧之间存在显著差异，健侧的AMEDA评分显著高于患侧（F = 22.508，<0.001）。跖屈的平均AMEDA评分显著高于内翻（F = 21.366，<0.001）。中风幸存者中，随着步行能力的增加，踝关节JPS敏锐度有显著的线性增加（F = 17.802，<0.001）。
中风后，患侧的踝关节JPS敏锐度低于健侧。与内翻运动相比，中风幸存者在跖屈运动中踝关节JPS敏锐度更高。总体而言，踝关节JPS敏锐度较高的中风幸存者往往步行能力更强，突出了踝关节JPS敏锐度在中风后步行能力中的重要性。这些发现为中风后本体感觉缺陷及其在神经康复中的相关性提供了新的见解。
