Proprioception of the Shoulder After Stroke

Abstract Niessen MH, Veeger DH, Koppe PA, Konijnenbelt MH, van Dieen J, Janssen TW. Proprioception of the shoulder after stroke. Objective To investigate position sense and kinesthesia of the shoulders of stroke patients. Design Case-control study. Setting A rehabilitation center. Participants A total of 22 inpatients with stroke and 10 healthy control subjects. Interventions Not applicable. Main Outcome Measures Angular displacement (in degrees) for threshold to detection of passive motion (TDPM) tests and absolute error (in degrees) for passive reproduction of joint position tests. Results For patients, the TDPM for internal and external rotation was significantly higher for both the contralateral (paretic) side (internal, 7.92°±7.19°; external, 8.46°±8.87°) and the ipsilateral (nonparetic) side (internal, 4.86°±5.03°; external, 6.09°±9.15°) compared with the control group (internal, 1.83°±1.09°; external, 1.71°±.85°). Also, for internal rotation, TDPM was significantly higher for patients on the contralateral side compared with the ipsilateral side. For passive reproduction of joint position tests, no differences were found. Conclusions Both the contralateral and ipsilateral shoulders of stroke patients showed impaired TDPM. Passive reproduction of joint position does not seem to be affected as a result of a stroke. The control of the muscle spindles and central integration or processing problems of the afferent signals provided by muscle spindles might cause these effects.