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Age-based model for metacarpophalangeal joint proprioception in elderly

Authors Rinderknecht MD, Lambercy O, Raible V, Liepert J, Gassert R

Received 8 December 2016

Accepted for publication 8 March 2017

Published 6 April 2017 Volume 2017:12 Pages 635—643

DOI https://doi.org/10.2147/CIA.S129601

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Akshita Wason

Peer reviewer comments 2

Editor who approved publication: Dr Richard Walker


Mike D Rinderknecht,1 Olivier Lambercy,1 Vanessa Raible,2 Joachim Liepert,2 Roger Gassert1

1Rehabilitation Engineering Laboratory, Department of Health Sciences and Technology, Institute of Robotics and Intelligent Systems, ETH Zurich, Zurich, Switzerland; 2Department of Neurorehabilitation, Kliniken Schmieder, Allensbach, Germany

Abstract: Neurological injuries such as stroke can lead to proprioceptive impairment. For an informed diagnosis, prognosis, and treatment planning, it is essential to be able to distinguish between healthy performance and deficits following the neurological injury. Since there is some evidence that proprioception declines with age and stroke occurs predominantly in the elderly population, it is important to create a healthy reference model in this specific age group. However, most studies investigate age effects by comparing young and elderly subjects and do not provide a model within a target age range. Moreover, despite the functional relevance of the hand in activities of daily living, age-based models of distal proprioception are scarce. Here, we present a proprioception model based on the assessment of the metacarpophalangeal joint angle difference threshold in 30 healthy elderly subjects, aged 55–80 years (median: 63, interquartile range: 58–66), using a robotic tool to apply passive flexion–extension movements to the index finger. A two-alternative forced-choice paradigm combined with an adaptive algorithm to define stimulus magnitude was used. The mixed-effects model analysis revealed that aging has a significant, increasing effect on the difference threshold at the metacarpophalangeal joint, whereas other predictors (eg, tested hand or sex) did not show a significant effect. The adaptive algorithm allowed reaching an average assessment duration <15 minutes, making its clinical applicability realistic. This study provides further evidence for an age-related decline in proprioception at the level of the hand. The established age-based model of proprioception in elderly may serve as a reference model for the proprioceptive performance of stroke patients, or of any other patient group with central or peripheral proprioceptive impairments. Furthermore, it demonstrates the potential of such automated robotic tools as a rapid and quantitative assessment to be used in research and clinical settings.

Keywords:
aging, difference threshold, hand function, joint position sense, MCP, robotic assessment, presbypropria, somatosensation

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