Unveiling the Hidden Challenges of Proprioception After Stroke: A New Robotic Testing Method
A decade ago, at age 55, Don Lewis’ life changed forever when he suffered a stroke in his sleep. The aftermath left him paralyzed on one side, unable to move his left arm or leg. This story is not unique; many stroke survivors face similar challenges. But what sets Lewis apart is his determination to help others understand a lesser-known consequence of stroke: proprioception, the body’s intricate ability to sense movement and position.
The Proprioception Puzzle
Proprioception, often overlooked, is the body’s silent sentinel, ensuring we move with precision and awareness. Imagine trying to touch your nose with your eyes closed. If you struggle with this simple task, you might have impaired proprioception. This is a critical aspect of stroke recovery that has long been under the radar.
A New Robotic Approach
Jennifer Semrau, an associate professor of kinesiology and applied physiology at the University of Delaware, and her doctoral student, Joanna Hoh, have developed a groundbreaking robotic testing method. This innovative approach allows them to assess proprioception without requiring patients to move their affected arms, making it more accessible in clinical settings.
The KINARM Exoskeleton
In the lab, Lewis is equipped with a KINARM robotic exoskeleton that tracks his upper limb movement. This technology enables Semrau to delve into the neural and behavioral mechanisms contributing to his sensory and motor recovery. By moving Lewis’ stroke-affected arm robotically, they can gauge his perception-based movement.
Unraveling the Sensory Mystery
The communication from the brain to the receptors in the muscles, responsible for detecting movement, is disrupted after a stroke. This disruption can lead to proprioceptive deficits, where individuals might feel pain but struggle with controlling their movements. Semrau explains that pain and touch are part of the somatosensory system, relayed through different nerve pathways.
The Interplay of Sensory and Motor Deficits
One of the challenges Semrau and Hoh face is distinguishing between sensory and motor deficits, as they are deeply intertwined. It’s a complex puzzle, as the tasks they study in the lab aim to uncover the core issue.
From Clinic to Classroom
Hoh, an occupational therapist, found her passion in upper-limb stroke research after working with patients in rehabilitation. She recognized the need to explore the sensory system’s role in stroke recovery, inspiring her to pursue a doctorate in biomechanics and movement science at UD. Her research focuses on sensory issues post-stroke and their impact on daily activities.
The Call for Awareness and Precision Testing
Semrau and Hoh emphasize the importance of raising awareness about proprioception deficits and encouraging clinicians to incorporate precision testing. Their research reveals a startling statistic: only 1% of clinicians assess proprioception in stroke patients. This highlights the need for a paradigm shift in stroke rehabilitation.
Personalized Medicine in Stroke Treatment
The duo stresses the necessity of understanding post-stroke impairments to develop personalized treatment approaches. Hoh states, ‘Just because someone is impaired motorically doesn’t mean they won’t have sensory issues.’ Semrau adds, ‘Understanding the connection between motor and sensory impairments is crucial for targeted therapies and tailored recovery plans.’
This research not only sheds light on the hidden challenges of stroke recovery but also paves the way for a more comprehensive and personalized approach to rehabilitation.