Effect of proprioception disturbance on activities of daily living (ADL) after stroke

Objective: To evaluate the effect of proprioception disturbance on basic activities of daily living (B-ADL) after stroke. Methods: 67 stroke patients consecutively admitted to the Heilongjiang Province Rehabilitation Hospital were classified upon admission as having proprioception disturbance (group A; n = 32; 47% of the entire sample) or not having such disturbance (group B; n = 35; 53%, of the sample). By 'thumb finding' test, 'heel-knee-shin' test and 'up or down' test,we examined the proprioception. When 2 of the 3 tests are abnormal or more,we thought the patient had proprioception disturnbance. Both groups received standard rehabilitation treatment including daily physiotherapy, occupational therapy, traditional Chinese medicine and other therapy in accord with individual needs. The Modified Barthel Index (MBI) was used to assess patients' capacity in B-ADL. Assessment was done upon admission to rehabilitation and 8 weeks afterwards. Results: Mean MBI scores at admission were 28.61 +/- 11.32 and 31.42 +/- 13.71 for groups A and B, respectively. At this point, the difference between the groups did not reach statistical significance (t=1.87,p>.05). After 8 weeks of intensive rehabilitation treatment, the MBI scores of both groups improved significantly (t=3.11,p <.01) and the average score of group A was lower than that of group B (group A - 43.23+/-10.82, group B - 62.73+/-15.61; p <.05) Conclusion: The existence of proprioception disturbance affects significantly the functional outcome of stroke patients. In view of the importance of this factor there is place for an effort to develop means for quantitative evaluation of the magnitude of the proprioception disturbance and therapeutic means aimed specifically to restore this sensory deficit.