http://nnr.sagepub.com/content/29/4/318?etoc
- Jennifer A. Semrau, PhD1,4
- Jeffery C. Wang1,4
- Troy M. Herter, PhD2
- Stephen H. Scott, PhD3
- Sean P. Dukelow, MD, PhD1,4
- 1University of Calgary, Calgary, AB, Canada
- 2University of South Carolina, Columbia, SC, USA
- 3Queen’s University, Kingston, ON, Canada
- 4Hotchkiss Brain Institute, Calgary, Alberta, Canada
- Sean P. Dukelow, University of Calgary, 1403 29th St NW, Foothills Medical Centre, South Tower, Room 905, Calgary, AB, T2N 2T9, Canada. Email: spdukelo@ucalgary.ca
-
Authors’ Note JAS and JCW contributed equally to this work.
Abstract
Background. After stroke, visuospatial and
kinesthetic (sense of limb motion) deficits are common, occurring in
approximately 30% and
60% of individuals, respectively. Although both
types of deficits affect aspects of spatial processing necessary for
daily
function, few studies have investigated the
relationship between these 2 deficits after stroke. Objective. We aimed to characterize the relationship between visuospatial and kinesthetic deficits after stroke using the Behavioral
Inattention Test (BIT) and a robotic measure of kinesthetic function. Methods.
Visuospatial attention (using the BIT) and kinesthesia (using robotics)
were measured in 158 individuals an average of 18
days after stroke. In the kinesthetic matching
task, the robot moved the participant’s stroke-affected arm at a preset
direction,
speed, and magnitude. Participants mirror-matched
the robotic movement with the less/unaffected arm as soon as they felt
movement
in their stroke affected arm. Results. We
found that participants with visuospatial inattention (neglect) had
impaired kinesthesia 100% of the time, whereas only
59% of participants without neglect were impaired.
For those without neglect, we observed that a higher percentage of
participants
with lower but passing BIT scores displayed
impaired kinesthetic behavior (78%) compared with those participants who
scored
perfect or nearly perfect on the BIT (49%). Conclusions.
The presence of visuospatial neglect after stroke is highly predictive
of the presence of kinesthetic deficits. However,
the presence of kinesthetic deficits does not
necessarily always indicate the presence of visuospatial neglect. Our
findings
highlight the importance of assessment and
treatment of kinesthetic deficits after stroke, especially in patients
with visuospatial
neglect.
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