BACKGROUND Position sense is commonly impaired after stroke. Traditional rehabilitation methods instruct patients to visualize their limbs to compensate for impaired position sense. OBJECTIVE Our goal was to evaluate how the use of vision influences impaired position sense. METHODS We examined 177 stroke survivors, an average of 12.7 days (+/- 10 days (SD)) post-stroke, and 133 neurologically-intact controls with a robotic assessment of position sense. The robot positioned one limb (affected) and subjects attempted to mirror-match the position using the opposite limb (unaffected). Subjects completed the test without, then with vision of their limbs. We examined three measures of position sense: variability (Var), contraction/expansion (C/E) and systematic shift (Shift). We classified stroke survivors as having full compensation if they performed the robotic task abnormally without vision but corrected performance within the range of normal with vision. Stroke survivors were deemed to have partial compensation if they performed the task outside the range of normal without and with vision, but improved significantly with vision. Those with absent compensation performed the task abnormally in both conditions and did not improve with vision. RESULTS Many stroke survivors demonstrated impaired position sense with vision occluded [Var: 116 (66%), C/E: 91 (51%), Shift: 52 (29%)]. Of those stroke survivors with impaired position sense, some exhibited full compensation with vision [Var: 23 (20%), C/E: 42 (46%), Shift: 32 (62%)], others showed partial compensation [Var: 37 (32%), C/E: 8 (9%), Shift: 3 (6%)] and many displayed absent compensation (Var: 56 (48%), C/E: 41 (45%), Shift: 17 (33%)]. Stroke survivors with an affected left arm, visuospatial neglect and/or visual field defects were less likely to compensate for impaired position sense using vision. CONCLUSIONS Our results indicate that vision does not help many stroke survivors compensate for impaired position sense, at least within the current paradigm. This contrasts with historical reports that vision helps compensate for proprioceptive loss following neurologic injuries.

中文翻译：

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视力并不总能帮助中风幸存者补偿受损的肢体位置感。

背景技术位置感通常在中风后受损。传统的康复方法指导患者想象自己的四肢，以补偿受损的位置感。目的 我们的目标是评估视觉的使用如何影响位置感受损。方法 我们检查了 177 名中风幸存者，中风后平均时间为 12.7 天（+/- 10 天（SD）），以及 133 名神经完整的对照组，并使用机器人评估位置感。机器人定位一侧肢体（受影响），受试者尝试使用另一肢（未受影响）镜像匹配该位置。受试者在没有四肢视力的情况下完成了测试，然后在有视力的情况下完成了测试。我们研究了位置感的三种测量方法：变异性 (Var)、收缩/扩张 (C/E) 和系统偏移 (Shift)。如果中风幸存者在没有视力的情况下异常执行机器人任务，但在视力正常的范围内纠正了表现，我们将中风幸存者分类为具有完全补偿。如果中风幸存者在无视力和有视力的情况下执行超出正常范围的任务，但视力有显着改善，则被认为获得部分补偿。那些没有补偿的人在这两种情况下都无法正常完成任务，而且视力也没有改善。结果 许多中风幸存者表现出位置感受损且视力遮挡 [Var：116 (66%)，C/E：91 (51%)，Shift：52 (29%)]。在那些位置感受损的中风幸存者中，一些人表现出视力的完全代偿 [Var: 23 (20%)，C/E: 42 (46%)，Shift: 32 (62%)]，其他人则表现出部分代偿 [Var: 37 (32%)、C/E: 8 (9%)、Shift: 3 (6%)] 和许多显示缺少补偿（Var: 56 (48%)、C/E: 41 (45%)、Shift: 17 (33%)]。左臂受影响、视觉空间忽视和/或视野缺陷的中风幸存者不太可能使用视觉来补偿受损的位置感。结论我们的结果表明，视力并不能帮助许多中风幸存者补偿受损的位置感。位置感，至少在当前范式内。这与历史报告形成鲜明对比，历史报告认为视觉有助于补偿神经损伤后本体感觉的丧失。