TY - JOUR
T1 - Motor-Equivalent Intersegmental Coordination Is Impaired in Chronic Stroke
AU - Subramanian, Sandeep K.
AU - Baniña, Melanie C.
AU - Sambasivan, Krithika
AU - Haentjens, Katherine
AU - Finestone, Hillel M.
AU - Sveistrup, Heidi
AU - Levin, Mindy F.
N1 - Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This project was supported by a Heart and Stroke Foundation Center for Stroke Recovery Catalyst Grant (HSFCSR PT-59562) to M.F. Levin, H. Sveistrup, and H.M. Finestone. M.F. Levin held a Canada Research Chair in Motor Recovery and Rehabilitation. H. Sveistrup was a Career Scientist with Ministry of Long-Term Health and Care, Ontario. S.K. Subramanian was supported by a Focus on Stroke Post-Doctoral Fellowship awarded by the Heart and Stroke Foundation of Canada. K. Haentjens received a summer studentship from the Canadian Stroke Network.
Funding Information:
We acknowledge the study participants, Rhona Guberek and Vira Rose for their assistance with patient recruitment and assessment, and Dr Valeri Goussev for programming assistance. The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This project was supported by a Heart and Stroke Foundation Center for Stroke Recovery Catalyst Grant (HSFCSR PT-59562) to M.F. Levin, H. Sveistrup, and H.M. Finestone. M.F. Levin held a Canada Research Chair in Motor Recovery and Rehabilitation. H. Sveistrup was a Career Scientist with Ministry of Long-Term Health and Care, Ontario. S.K. Subramanian was supported by a Focus on Stroke Post-Doctoral Fellowship awarded by the Heart and Stroke Foundation of Canada. K. Haentjens received a summer studentship from the Canadian Stroke Network.
Publisher Copyright:
© The Author(s) 2020.
PY - 2020/3/1
Y1 - 2020/3/1
N2 - Background. Kinematic abundance permits using different movement patterns for task completion. Individuals poststroke may take advantage of abundance by using compensatory trunk displacement to overcome upper limb (UL) movement deficits. However, movement adaptation in tasks requiring specific intersegment coordination may remain limited. Objective. We tested movement adaptation in both arms of individuals with chronic stroke (n = 16) and nondominant arms of controls (n = 12) using 2 no-vision reaching tasks involving trunk movement (40 trials/arm). Methods. In the “stationary hand task” (SHT), subjects maintained the hand motionless over a target while leaning the trunk forward. In the “reaching hand task” (RHT), subjects reached to the target while leaning forward. For both tasks, trunk movement was unexpectedly blocked in 40% of trials to assess the influence of trunk movement on adaptive arm positioning or reaching. UL sensorimotor impairment, activity, and sitting balance were assessed in the stroke group. The primary outcome measure for SHT was gain (g), defined as the extent to which trunk displacement contributing to hand motion was offset by appropriate changes in UL movements (g = 1: complete compensation) and endpoint deviation for RHT. Results. Individuals poststroke had lower gains and greater endpoint deviation using the more-affected compared with less-affected UL and controls. Those with less sensorimotor impairment, greater activity levels, and better sitting balance had higher gains and smaller endpoint deviations. Lower gains were associated with diminished UL adaptability. Conclusions. Tests of condition-specific adaptability of interjoint coordination may be used to measure UL adaptability and changes in adaptability with treatment.
AB - Background. Kinematic abundance permits using different movement patterns for task completion. Individuals poststroke may take advantage of abundance by using compensatory trunk displacement to overcome upper limb (UL) movement deficits. However, movement adaptation in tasks requiring specific intersegment coordination may remain limited. Objective. We tested movement adaptation in both arms of individuals with chronic stroke (n = 16) and nondominant arms of controls (n = 12) using 2 no-vision reaching tasks involving trunk movement (40 trials/arm). Methods. In the “stationary hand task” (SHT), subjects maintained the hand motionless over a target while leaning the trunk forward. In the “reaching hand task” (RHT), subjects reached to the target while leaning forward. For both tasks, trunk movement was unexpectedly blocked in 40% of trials to assess the influence of trunk movement on adaptive arm positioning or reaching. UL sensorimotor impairment, activity, and sitting balance were assessed in the stroke group. The primary outcome measure for SHT was gain (g), defined as the extent to which trunk displacement contributing to hand motion was offset by appropriate changes in UL movements (g = 1: complete compensation) and endpoint deviation for RHT. Results. Individuals poststroke had lower gains and greater endpoint deviation using the more-affected compared with less-affected UL and controls. Those with less sensorimotor impairment, greater activity levels, and better sitting balance had higher gains and smaller endpoint deviations. Lower gains were associated with diminished UL adaptability. Conclusions. Tests of condition-specific adaptability of interjoint coordination may be used to measure UL adaptability and changes in adaptability with treatment.
KW - arm-trunk coordination
KW - cerebrovascular accident
KW - kinematics
KW - upper limb
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U2 - 10.1177/1545968319899912
DO - 10.1177/1545968319899912
M3 - Article
C2 - 31976815
AN - SCOPUS:85078087779
SN - 1545-9683
VL - 34
SP - 210
EP - 221
JO - Neurorehabilitation and Neural Repair
JF - Neurorehabilitation and Neural Repair
IS - 3
ER -