A pilot study: effect of somatosensory loss on motor corrections in response to unknown loads in a reaching task by chronic stroke survivors

Abstract

Despite recent studies indicating a significant correlation between somatosensory deficits and rehabilitation outcomes, how prevailing somatosensory deficits affect stroke survivors' ability to correct their movements and recover overall remains unclear. To explore how major deficits in somatosensory systems impede stroke survivors' motor correction to various external loads, we conducted a study with 13 chronic stroke survivors who had hemiparesis. An inertial, elastic, or viscous load, which was designed to impose perturbing forces with various force profiles, was introduced unexpectedly during the reaching task using a programmable haptic robot. Participants' proprioception and cutaneous sensation were also assessed using passive movement detection, finger-to-nose, mirror, repositioning, and Weinstein pressure tests. These measures were then analyzed to determine whether the somatosensory measures significantly correlated with the estimated reaching performance parameters, such as initial directional error, positional deviation, velocity deviations, and speed of motor correction were measured. Of 13 participants, 5 had impaired proprioception, as they could not recognize the passive movement of their elbow joint, and they kept showing larger initial directional errors even after the familiarization block. Such continuously found inaccurate initial movement direction might be correlated with the inability to develop the spatial body map especially for calculating the initial joint torques when starting the reaching movement. Regardless of whether proprioception was impaired or not, all participants could show the stabilized, constant reaching movement trajectories. This highlights the role of proprioception especially in the execution of a planned movement at the early stage of reaching movement.