Abstract WP64: Wrist Proprioception In The Subacute Period After Stroke

Background: Proprioception is critical to motor control. The prevalence, severity, and clinical correlates of deficits in wrist proprioception early after stroke have received limited attention and were examined in patients admitted to an inpatient rehabilitation facility (IRF). Methods: Patients admitted for stroke to our IRF (n=18) and older healthy controls (n=12) completed the Wrist Position Sense Test (WPST), a validated, quantitative proprioception measure, as well as motor and cognitive testing. Patients were serially tested when available (n=12). Results: In controls, mean (± SD) WPST error was 9.1 ± 3.6 deg in the dominant wrist and 9.2 ± 4.5 deg in the nondominant wrist. In patients with stroke, WPST error was 18.6 ± 9 deg in the more affected wrist, with abnormal values present in 88.2%; and 11.5 ± 5.6 deg in the less affected wrist, which was abnormal in 55.6% of patients. Error in the more affected wrist was higher than in the less affected wrist (p=0.003), dominant wrist of controls (p=0.001), and nondominant wrist of controls (p=0.003). Retesting in patients a mean of 11 days later found error was not significantly changed (17 ± 7.7 deg in more affected wrist and 15.6 ± 16.3 deg in less affected). Among controls, higher dominant hand WPST error correlated with poorer 9-hole peg (rho=0.75, FDR-corrected p=0.048) and Box & Blocks (r=-0.77, FDR-corrected p=0.048) scores; these relationships were not seen in patients with stroke. WPST error in either hand of patients with stroke was not related to MoCA, NIHSS, or Fugl-Meyer scores. ConclusionS: Deficits in wrist proprioception are common early after stroke, with average error twice that of healthy controls. These differences are not explained by cognitive or motor deficits. Relationships that proprioception has with motor function in healthy subjects are disrupted early after stroke.