Relationship of Ankle Proprioception Measured in Weight Bearing with Balance and Walking Ability in People with Stroke: a Cross-sectional Study

Background: Proprioceptive deficits are common after stroke. However, limited research has investigated their relationship with functional outcomes (balance and walking ability), particularly in weight-bearing conditions.

Objectives: This study aimed to investigate ankle proprioception on both sides (affected and unaffected), measured in biaxial movement directions (plantar flexion and inversion) and relationships with balance and walking ability in stroke survivors.

Methods: This cross-sectional study involved 70 mild to moderate, first-time, unilateral stroke survivors. Ankle proprioception was measured in a weight-bearing standing position, using the active movement extent discrimination apparatus (AMEDA). Balance and walking ability were measured using the Berg Balance Scale (BBS), the 10-Meter Walking Test (10MWT) and the Timed Up and Go Test (TUG).

Results: Ankle proprioception showed moderate correlations with balance and walking ability (0.4<|r|<0.6, all  < 0.001), regardless of side or movement direction. The only exception was proprioceptive acuity scores for plantar flexion movements made on the unaffected side, which were weakly correlated with BBS ( = 0.3,  = 0.006) and TUG ( = 0.3,  = 0.0015). Regression analysis indicated that ankle proprioception for inversion movement on the affected side was the only factor to independently predict balance (BBS,  = 0.001) and walking ability (10MWT:  < 0.001; TUG:  = 0.01). Ankle proprioception predicts 36% of the variation in BBS, 38% of the variation in 10MWT and 28% of the variation in TUG.

Conclusion: Ankle proprioception showed moderate associations with balance and walking ability in people with mild to moderate stroke. These findings suggest that ankle proprioception could potentially be an indicator of post-stroke functional outcomes, warranting further investigation.