Objective Accuracy Indicators of the Single-Joint Arm Movements Simultaneous Reproduction with Closed Eyes and under Visual Control in Patients with Hemiparesis and Healthy Test Subjects (a New Method for Proprioceptive Sensitivity Objective Assessment)
1 Institute of Higher Nervous Activity and Neurophysiology of the Russian Academy of Sciences, Moscow, Russian Federation
2 NeuroBioLab LLC, Moscow, Russian Federation
3 Institute of Medical and Biological Problems of the Russian Academy of Sciences, Moscow, Russian Federation
4 Federal Center for Brain and Neurotechnology, Moscow, Russian Federation
5 Institute for Information Transmission Problems of the Russian Academy of Sciences, Moscow, Russian Federation
6 Central Clinical Hospital of the Russian Academy of Sciences, Moscow, Russian Federation
7 Medical and Rehabilitation Center, Moscow, Russian Federation
8 Pirogov Russian National Research Medical University, Moscow, Russian Federation
Aim. We have developed a method for objective assessment of proprioceptive sensitivity (PS) based on determining the accuracy ofreproduction with the eyes closed of the tested arm passive single-joint movements by active movements of the other arm duringtheir execution. It was shown that healthy test subjects reproduce the passive movements with high accuracy, while post-stroke patientswith hemiparesis reproduce a large proportion of paretic arm test movements with gross qualitative and quantitative errors. Tomake sure that the reproduction errors are associated with the state of PS but not with the cognitive factor or the functional state ofthe conditionally healthy arm, it was necessary to find out how accurately these patients are able to reproduce the test-movementsunder visual control.Materials and Methods. In 11 patients with a lesion in the right and in 9 patients in the left hemispheres of the brain and a controlgroup of 23 healthy subjects, the accuracy of reproduction of the 5 elementary hand movements was studied: flexion-extension in theshoulder, elbow and wrist joints and abduction–adduction in the shoulder and wrist joints. The test person was subjected to a seriesof passive cyclic movements of the test hand during which he had to copy them with active movements of the other hand. The reproductionprocedure for each test movement was performed first under visual control and then with the eyes closed. The angles in thetest join and the same joint of the other arm were recorded. Qualitative and quantitative indicators were used to assess the degree ofsimilarity of active and passive movements and to reveal the correspondence of copying accuracy to the previously developed conditionalcriterion of the norm (CCN) of PS in healthy test subjects.Results. It was shown that in healthy test subjects the accuracy of all movements copying in tests with closed eyes and 98% of movementsin tests with opened eyes met the requirements of the CCN. In the group of patients in tests with eyes closed, copying only 61%of movements met this criterion. 20.4% of movements were reproduced with qualitative gross errors, 18.4% were copied qualitativelycorrectly but differed from CCN in quantitative indicators. In tests with visual tracking of passive movements, reproduction of 98% ofmovements was qualitatively correct and 83% of movements corresponded to CCN.Conclusions. The vast majority of single-articular movements of the paretic arm are copied by patients with unilateral brain damageunder visual control qualitatively correctly and accurately (meeting the CCN). It means that in the course of the study of PS by the proposedmethod, they, as a rule, understand the motor task and can reproduce the tested movements with their conditionally healthyarm. From this it follows that the main cause of these movements impaired copying in tests with closed eyes is proprioceptive deficit.
Keywords: proprioception, visual control, single-joint arm movements, unilateral brain lesion, hemiparesis, rehabilitation
For citation: Pavlova O.G., Roschin V.Yu., Sidorova M.V., Selionov V.A., Nikolaev E.A., Khatkova S.E., Ivanova G.E. Objective Accuracy Indicators of the Single-Joint Arm Movements Simultaneous Reproduction with Closed Eyes and under Visual Control in Patients with Hemiparesis and Healthy Test Subjects (a New Method for Proprioceptive Sensitivity Objective Assessment). Bulletin of Rehabilitation Medicine. 2020; 20(1): 35-44. https://doi.org/10.38025/2078-1962-2021-20-1-35-44
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