Vision and Proprioception Evaluation With Robotics After Stroke

Stroke is highly prevalent in Canada and can lead to profound upper limb impairments in motor and sensory function, as well and vision. Clinical assessments for these functions often lack sensitivity making detecting impairments and tracking their recovery after stroke difficult. It is known that sensory function and vision interact to inform motor behaviours, yet how each of these modalities might contribute to motor impairments and subsequent recovery after stroke is undetermined.

Using robotics to assess neurologic function after a stroke can be very beneficial, as they can measure on the scale of millimetres and milliseconds which can more easily detect subtle deficits in a persons function. Compared to current clinical tools, robotics offer greater objectivity and reliability, as they do not rely on the examiners clinical experience and/or impression. The use of robotics not only offers a more precise measurement, but robotics assessments can be completed in a relatively short amount of time, in comparison to some of the current clinical assessment tools, which can take along time to complete. In addition to robotics, collecting neuroimaging (MRI/CT) will allow us to relate our robotic and eye-tracking measures to neuroanatomical information about the person's stroke. With this data, we will assess how the brain changes post-stroke in relation to the recovery of motor, sensory and visual functions.

This research will: 1) examine the relationship between visual and proprioceptive impairment on motor and eye movement behaviour over time after stroke, and 2) identify neuroanatomical correlates of visual, proprioceptive and sensory integrative dysfunction that impact motor recovery after stroke and examine the ability of regional damage and network disruption to predict recovery.

Objectives:

1. Determine the impact of visual field loss and visual neglect in stroke survivors with impaired movement over the first 6 months post-stroke.
2. Identify the impact of Proprioceptive Impairment and Sensory Integration Impairment on recovery post-stroke using robotics and eye tracking.
3. Understand the impact of damage to neuroanatomic structures involved in vision, proprioception and sensory integration on motor recovery using MRI after stroke.

The VIPERS study is recruiting both stroke and control participants. Stroke participants are recruited within the first 28 days post-stroke and are assessed longitudinally across the first 6-months post-stroke (four study timepoints). Control participants just complete a single session.