Effects Of Proprioceptive Training With Visual Feedback On Upper Limb Function After Stroke

Objective:To analyze the correlation between upper-limb sensory function with motor function and activities of daily living in patients with stroke.To design a proprioceptive training paradigm and observe the clinical efficacy of the paradigm on patients with upper limb impairment after stroke.The aim of this study was to provide support for the clinical application of proprioceptive training in stroke patients.Methods:1.Somatosensory measurement comprised the Semmes Weinstein Monofilaments Examination(SWME),Fugl-Meyer Assessment-Upper Extremity sensory subscale(FMA-UE-S)and the Two-Point Discrimination test(2PD).Upper-limb motor assessment include the Fugl-Meyer Assessment-Upper Extremity motor subscale(FMA-UE-M)and Action Research Arm test(ARAT).The Barthel index(BI)was used to assess ADL.Correlations were used to investigate the relationships between upper-limb sensory function with motor function and activities of daily living after stroke.2.A single-blinded,prospective parallel-group controlled trial was conducted in this study.40 patients with upper limb impairment after stroke were randomly assigned to the proprioceptive training group(PG)and the control group(CG).Both groups of patients received conventional rehabilitation treatment.In addition,patients in PG received proprioceptive training involving passive and active movements with visual feedback,and patients in PG received non-specific sensory stimulation for 30 minutes each time,5 times a week for 4 weeks.FMA-UE-M,Box and Blocks Test(BBT),Thumb Localization Test(TLT),FMA-UE-S and BI were used to assess the upper limb function and ADL.The effect of proprioceptive training was investigated by comparing the two groups of patients before and after the intervention in both within and between groups.Results:1.Cross-sectional study: Low correlations were found between SWME with FMA-UE-M(r = 0.316),ARAT(r = 0.293),and BI(r = 0.341).In addition,low correlations were found for the association between FMA-UE-S with FMA-UE-M(r = 0.413),ARAT(r =0.361),and BI(r = 0.331).However,there were no significant association between 2PD with FMA-UE-M、ARAT and BI(P > 0.05).2.Parallel-group controlled trial: After 4 weeks of intervention: The PG showed a significantly greater improvement in FMA-UE-M,TLT and FMA-UE-S than CG(P <0.05).There was no significant differences between the two groups in the results of BBT and BI.Conclusions:1.Upper limb tactile and proprioceptive function are positively associated with motor function and activities of daily living after stroke.2.Proprioceptive training combined passive and active training with visual feedback improved the upper limb sensorimotor function in stroke patients.