Data_Sheet_2_Correlation Between Proprioceptive Impairment and Motor Deficits After Stroke: A Meta-Analysis Review.pdf

Introduction: Proprioceptive impairment is a common symptom after stroke. Clarifying how proprioception correlates with motor function after stroke may be helpful in optimizing proprioception-augmented movement training. Previous studies have shown inconsistent findings. A meta-analysis is an optimal method to explore the correlation and identify the factors contributing to these inconsistencies.
Objective: To explore the correlation between proprioception and motor function after stroke through a meta-analysis, taking into account characteristics of the measurements used in these studies.
Methods: We searched multiple databases until November 2021 for eligible studies that measured both proprioception and motor functions in persons with stroke and reported their correlation or data for correlation analysis. A meta-analysis of the correlations was performed. The subgroup analysis and meta-regression were further conducted to investigate potential factors contributing to the heterogeneity of correlation strength, based on the participants' characteristics, proprioception, and motor function measures.
Results: In total, 28 studies comprising of 1,829 participants with stroke were included in the meta-analysis. The overall correlation between proprioception and motor function was significant (r = 0.267, p < 0.05), but there was heterogeneity across studies (I2 = 45%, p < 0.05). The results of the subgroup analysis showed proprioception of the axial segment in weight-bearing conditions (r = 0.443, p < 0.05) and upper limb without weight-bearing (r = 0.292, p < 0.05) had a stronger correlation with motor function than proprioception of the lower limb without weight-bearing. The proprioception measured through ipsilateral matching (r = 0.412, p < 0.05) showed a stronger correlation with motor function than through contralateral matching. The International Classification of Functioning, Disability, and Health (ICF) domains of motor function, movement function (r = 0.338, p < 0.05), activity performance (r = 0.239, p < 0.05), and independence (r = 0.319, p < 0.05) showed a stronger correlation with proprioception than with other domains.
Conclusion: There is a significant correlation between proprioception and motor dysfunction after stroke. The proprioception measured in the axial segment under weight-bearing conditions or measured with ipsilateral matching, and motor function, specifically in the ICF domains of movement function, activity performance, and independence showed a positive contribution to the association between proprioception and motor function. The correlation does not imply causation and might be underestimated by attributes of current tests for proprioception and motor function. Further studies are needed to clarify the cause-effect relationship.

引言：本体感觉障碍（proprioceptive impairment）是脑卒中后常见症状。明确脑卒中后本体感觉与运动功能的关联，有助于优化本体感觉增强型运动训练方案。既往相关研究结论存在不一致，而元分析（meta-analysis）是探索二者关联并明确导致结论异质性的潜在因素的最优方法。

目的：本研究拟通过元分析，结合各项研究中所采用的测量方法特征，探讨脑卒中后本体感觉与运动功能的相关性。

方法：我们检索了截至2021年11月的多个数据库，筛选同时测量脑卒中患者本体感觉与运动功能、并报告了二者相关性或可用于相关性分析数据的符合纳入标准的研究。随后开展相关性元分析，并基于受试者特征、本体感觉与运动功能的测量方式，进一步进行亚组分析与元回归分析，以探究影响关联强度异质性的潜在因素。

结果：本研究共纳入28项研究，涉及1829名脑卒中患者。整体分析显示，本体感觉与运动功能间存在显著相关性（r=0.267，p<0.05），但各研究间存在异质性（I²=45%，p<0.05）。亚组分析结果表明：负重状态下轴性节段本体感觉（r=0.443，p<0.05）与非负重状态上肢本体感觉（r=0.292，p<0.05）与运动功能的相关性，均强于非负重状态下肢本体感觉；同侧匹配法测量的本体感觉（r=0.412，p<0.05）与运动功能的相关性，强于对侧匹配法。运动功能的国际功能、残疾和健康分类（ICF）域中，运动功能（r=0.338，p<0.05）、活动表现（r=0.239，p<0.05）与独立性（r=0.319，p<0.05）维度与本体感觉的相关性，均高于其他维度。

结论：脑卒中后本体感觉与运动功能损害间存在显著相关性。在负重状态下轴性节段或采用同侧匹配法测量的本体感觉，以及运动功能的ICF运动功能、活动表现与独立性维度，均对二者的关联存在正向贡献。本研究发现的相关性并非因果关联，且当前本体感觉与运动功能的测量工具可能低估了二者的实际关联强度，未来需开展进一步研究以明确二者间的因果关系。