Shen X1,2, Chen YF1, Yu YF1, Lou T1
1Tongji University School of Medicine, Department of Rehabilitation Sciences, Shanghai, China, 2Yangzhi Rehabilitation Hospital Affiliated to Tongji University, Shanghai, China
Background: Proprioceptive impairment is common after stroke. It is generally recognized that proprioceptive impairment may affect the motor recovery in stroke patients. Proprioception enhancement is therefore important for these patients. However, nowadays, there has not been consensus on optimal proprioception enhancement training. Clarification of the correlation between proprioception and motor function may help to guide the design of proprioception enhancing training integrated with movement therapy. Some studies have done however reported inconsistent findings.
Purpose: A meta-analysis review is a proper method to identify the common correlation of them and further clarify the correlation of their subtypes, which are purposes of this study.
Methods: We conducted an extensive search of the literature, through electronic databases, including Web of science, CINAHL, SportDiscus, MEDLINE, PubMed, and Academic Search Premier via EbscoHost, using a combination of terms related to stroke, proprioception and motor function. The studies were selected according to PRSIMA guideline. The data of proprioception and motor function were extracted and their subtypes were classified, including 3 subtypes of proprioception (position, velocity and direction senses), 7 subtypes of motor function (movement strength, speed, direction, and coordination, muscle tension, general movement performance and general functional performance). The methodology quality of the pooled studies was evaluated using the Modified Quality Assessment of Studies of Diagnostic Accuracy (QUASDA) scale. A meta-analysis was conducted between pooled studies. When two or more subtypes of proprioception or motor function were reported in one study, the mean value of the same category measures were used to determine the correlation. The significant level was set at 5%.
Results: 9 studies were included into the meta-analysis, 4 studies with high and moderate quality of methodology respectively, and 1 study with low quality based on risk of bias judgment of QUASDA. The correlation between proprioception and motor function in all studies showed significant (r=0.316, p=0.001). Among the subtypes of proprioception, all studies tested position sense and showed significant correlation with motor function. (r=0.306, p=0.002), whilst only one study measured speed sense and showed significant correlation with motor function (r=0.269, p=0.001), the same as the direction sense which showed significant and slightly higher correlation with motor function (r=0,418, p 0.001). For the motor function, 6 studies measured general movement performance and showed significant correlation with proprioception (r=0.315, p=0.008), 4 studies measured general functional performance and found significant but low correlation with proprioception (r=0.142, p=0.022). There are respective 3 studies measuring movement speed and muscle tension which did not find significant correlation with proprioception. For movement direction and strength and coordination, only one study measure each of them respectively and only the movement strength showed significant correlation with proprioception (r=0.374, p 0.001).
Conclusion(s): In conclusion, proprioception significantly correlates with motor function. Subtypes of proprioception showed similar correlation with motor function, however, subtypes of motor function demonstrated variations of their correlation with proprioception that movement performance showed strongest correlation with proprioception.
Implications: The findings provide evidences to support the proprioception enhancing training integrated with movement therapy, further, indicate that general performance-focused movement therapy could be the optimal protocol for proprioception enhancement.
Keywords: proprioception, motor function, Stroke
Funding acknowledgements: There is no funding to support this study.
Purpose: A meta-analysis review is a proper method to identify the common correlation of them and further clarify the correlation of their subtypes, which are purposes of this study.
Methods: We conducted an extensive search of the literature, through electronic databases, including Web of science, CINAHL, SportDiscus, MEDLINE, PubMed, and Academic Search Premier via EbscoHost, using a combination of terms related to stroke, proprioception and motor function. The studies were selected according to PRSIMA guideline. The data of proprioception and motor function were extracted and their subtypes were classified, including 3 subtypes of proprioception (position, velocity and direction senses), 7 subtypes of motor function (movement strength, speed, direction, and coordination, muscle tension, general movement performance and general functional performance). The methodology quality of the pooled studies was evaluated using the Modified Quality Assessment of Studies of Diagnostic Accuracy (QUASDA) scale. A meta-analysis was conducted between pooled studies. When two or more subtypes of proprioception or motor function were reported in one study, the mean value of the same category measures were used to determine the correlation. The significant level was set at 5%.
Results: 9 studies were included into the meta-analysis, 4 studies with high and moderate quality of methodology respectively, and 1 study with low quality based on risk of bias judgment of QUASDA. The correlation between proprioception and motor function in all studies showed significant (r=0.316, p=0.001). Among the subtypes of proprioception, all studies tested position sense and showed significant correlation with motor function. (r=0.306, p=0.002), whilst only one study measured speed sense and showed significant correlation with motor function (r=0.269, p=0.001), the same as the direction sense which showed significant and slightly higher correlation with motor function (r=0,418, p 0.001). For the motor function, 6 studies measured general movement performance and showed significant correlation with proprioception (r=0.315, p=0.008), 4 studies measured general functional performance and found significant but low correlation with proprioception (r=0.142, p=0.022). There are respective 3 studies measuring movement speed and muscle tension which did not find significant correlation with proprioception. For movement direction and strength and coordination, only one study measure each of them respectively and only the movement strength showed significant correlation with proprioception (r=0.374, p 0.001).
Conclusion(s): In conclusion, proprioception significantly correlates with motor function. Subtypes of proprioception showed similar correlation with motor function, however, subtypes of motor function demonstrated variations of their correlation with proprioception that movement performance showed strongest correlation with proprioception.
Implications: The findings provide evidences to support the proprioception enhancing training integrated with movement therapy, further, indicate that general performance-focused movement therapy could be the optimal protocol for proprioception enhancement.
Keywords: proprioception, motor function, Stroke
Funding acknowledgements: There is no funding to support this study.
Topic: Neurology: stroke
Ethics approval required: No
Institution: Yangzhi Rehabilitation Hospital Afflitated to Tongji University
Ethics committee: Ethics Committee of Yangzhi Rehabilitation Hospital Afflitated to Tongji University
Reason not required: This is a meta-analysis review study.
All authors, affiliations and abstracts have been published as submitted.
