Assessing bilateral ankle proprioceptive acuity in stroke survivors: An exploratory study

Li Pan; Dongyan Xu; Weining Wang; Jifeng Rong; Jinyao Xu; Amanda Ferland; Roger Adams; Jia Han; Yulian Zhu

doi:10.3389/fneur.2022.929310

Assessing bilateral ankle proprioceptive acuity in stroke survivors: An exploratory study

Front Neurol. 2022 Aug 11:13:929310. doi: 10.3389/fneur.2022.929310. eCollection 2022.

Authors

Li Pan^{1

2}, Dongyan Xu¹, Weining Wang¹, Jifeng Rong³, Jinyao Xu⁴, Amanda Ferland⁵, Roger Adams⁴, Jia Han^{2

4

6

7}, Yulian Zhu¹

Affiliations

¹ Department of Rehabilitation Medicine, Huashan Hospital Fudan University, Shanghai, China.
² School of Kinesiology, Shanghai University of Sport, Shanghai, China.
³ The First Rehabilitation Hospital of Shanghai, Shanghai, China.
⁴ Research Institute for Sport and Exercise, University of Canberra, Canberra, NSW, Australia.
⁵ USC Division of Biokinesiology and Physical Therapy, Orthopedic Physical Therapy Residency, and Spine Rehabilitation Fellowship, The First Rehabilitation Hospital of Shanghai, Shanghai, China.
⁶ College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, China.
⁷ Faculty of Health, Arts and Design, Swinburne University of Technology, Melbourne, VIC, Australia.

Abstract

Background: Bilateral proprioception deficits were reported in stroke survivors. However, whether bilateral proprioception deficits exist in the ankle joint after stroke was unclear. Ankle proprioception is a significant predictor of balance dysfunction after stroke, and previous studies to date are lacking appropriate evaluation methods.

Objectives: We want to determine whether the active movement extent discrimination apparatus (AMEDA) is a reliable tool for assessing ankle proprioceptive acuity in stroke survivors and the presence of deficits in ankle proprioception on the affected and unaffected sides in patients after stroke.

Methods: Bilateral ankle proprioception was assessed in 20 stroke patients and 20 age-matched healthy controls using AMEDA. Test-retest reliability was assessed using the intraclass correlation coefficient (ICC).

Results: The ICC in the affected and unaffected sides was 0.713 and 0.74, respectively. Analysis of variance revealed significant deficits in ankle proprioception in subacute stroke survivors vs. healthy controls (F = 2.719, p = 0.045). However, there were no significant differences in proprioception acuity scores between the affected and unaffected sides in patients after stroke (F = 1.14, p = 0.331).

Conclusions: Stroke survivors had bilateral deficits in ankle proprioceptive acuity during active movements compared with age-matched healthy controls, underscoring the need to evaluate these deficits on both sides of the body and develop effective sensorimotor rehabilitation methods for this patient population. The AMEDA can reliably determine bilateral ankle proprioceptive acuity in stroke survivors.

Keywords: ankle; bilateral; mobility; motor control; proprioception; stroke.