Article

Perinatal stroke is the leading cause of hemiparetic cerebral palsy.
Motor deficits and their treatment are commonly emphasized in the literature.
Sensory dysfunction may be an important contributor to disability, but it is
difficult to measure accurately clinically. Objective :
Use robotics to quantify
position sense deficits in hemiparetic children with perinatal stroke and
determine their association with common clinical measures. Methods : Case-control
study : Participants were children aged 6 to 19 years with magnetic resonance
imaging-confirmed unilateral perinatal arterial ischemic stroke or
periventricular venous infarction and symptomatic hemiparetic cerebral palsy.
Participants completed a position matching task using an exoskeleton robotic
device (KINARM). Position matching variability, shift, and expansion/contraction
area were measured with and without vision. Robotic outcomes were compared across
stroke groups and controls and to clinical measures of disability (Assisting Hand
Assessment) and sensory function. Results Forty stroke participants (22 arterial,
18 venous, median age 12 years, 43% female) were compared with 60 healthy
controls. Position sense variability was impaired in arterial (6.01 +/- 1.8 cm)
and venous (5.42 +/- 1.8 cm) stroke compared to controls
(3.54 +/- 0.9 cm, P <
.001) with vision occluded. Impairment remained when vision was restored. Robotic
measures correlated with functional disability.
Sensitivity and specificity of
clinical sensory tests were modest. Conclusions Robotic assessment of position
sense is feasible in children with perinatal stroke. Impairment is common and
worse in arterial lesions. Limited correction with vision suggests cortical
sensory network dysfunction. Disordered position sense may represent a
therapeutic target in hemiparetic cerebral palsy.
CI - (c) The Author(s) 2016.

Langue : ANGLAIS