TY - JOUR
T1 - Temporal and spatial control following bilateral versus unilateral training
AU - McCombe Waller, S.
AU - Liu, W.
AU - Whitall, J.
N1 - Funding Information:
The authors thank the participants in this study and also the trainers, testers, and nurses in the Pepper Centers and GRECC who assisted with the testing and training. The study was supported in part by the Baltimore Veterans Administration Geriatrics Research, Education and Clinical Center, P60AG12583; PI AG (Claude D. Pepper Older Americans Independence Center, and NIDDR H).
PY - 2008/10
Y1 - 2008/10
N2 - Principles of motor control and learning such as bilateral coordination and task-specificity, are increasingly incorporated in the design of upper extremity rehabilitation protocols for stroke survivors. Yet most studies investigating the efficacy of new protocols report composite scores of standardized tests, such as the Fugl-Meyer Upper Extremity test (FM) and the Wolf Motor Arm Test, rather than determining how the motor control and coordination of arm movements has changed. Here we present a sub-study of a larger randomized controlled trial comparing a bilateral and unilateral training protocol where participants were assessed on bilateral and unilateral arm reaching. Eligible participants for the arm reaching analysis were 9 (FM = 37) and 9 (FM = 34) in Bilateral Arm Training with Rhythmic Auditory Cueing (BATRAC) and Dose Matched Therapeutic Exercises (DMTE), respectively. Participants undertook 18 sessions of training for 6 weeks with 20 min of active training per session. For bilateral arm reaching, participants after BATRAC were faster, with increased peak acceleration, fewer movement units, and smoother hand paths for each arm. The BATRAC training group showed greater improvements with training than the DMTE group during bilateral reaching for parameters of movement units and smoothness of hand path. For unilateral arm reaching, participants were faster after DMTE for paretic arm reaching; however, this group did not improve to a greater extent than the BATRAC training group. Within group functional gains were seen after BATRAC on FM, Wolf Motor Arm Test (time and weight) and after DMTE on FM and Wolf Weight. There was a positive correlation between movement units and the time component of the Wolf Motor Arm Test. The reaching analysis demonstrates task-specificity in training since BATRAC improves performance in bilateral reaching and DMTE improves performance in unilateral reaching. Temporal/spatial control outcomes in studies of post-stroke interventions can identify functionally relevant motor control changes that are not captured by traditional standardized tests.
AB - Principles of motor control and learning such as bilateral coordination and task-specificity, are increasingly incorporated in the design of upper extremity rehabilitation protocols for stroke survivors. Yet most studies investigating the efficacy of new protocols report composite scores of standardized tests, such as the Fugl-Meyer Upper Extremity test (FM) and the Wolf Motor Arm Test, rather than determining how the motor control and coordination of arm movements has changed. Here we present a sub-study of a larger randomized controlled trial comparing a bilateral and unilateral training protocol where participants were assessed on bilateral and unilateral arm reaching. Eligible participants for the arm reaching analysis were 9 (FM = 37) and 9 (FM = 34) in Bilateral Arm Training with Rhythmic Auditory Cueing (BATRAC) and Dose Matched Therapeutic Exercises (DMTE), respectively. Participants undertook 18 sessions of training for 6 weeks with 20 min of active training per session. For bilateral arm reaching, participants after BATRAC were faster, with increased peak acceleration, fewer movement units, and smoother hand paths for each arm. The BATRAC training group showed greater improvements with training than the DMTE group during bilateral reaching for parameters of movement units and smoothness of hand path. For unilateral arm reaching, participants were faster after DMTE for paretic arm reaching; however, this group did not improve to a greater extent than the BATRAC training group. Within group functional gains were seen after BATRAC on FM, Wolf Motor Arm Test (time and weight) and after DMTE on FM and Wolf Weight. There was a positive correlation between movement units and the time component of the Wolf Motor Arm Test. The reaching analysis demonstrates task-specificity in training since BATRAC improves performance in bilateral reaching and DMTE improves performance in unilateral reaching. Temporal/spatial control outcomes in studies of post-stroke interventions can identify functionally relevant motor control changes that are not captured by traditional standardized tests.
KW - Bilateral and unilateral training
KW - Spatial motor control
KW - Temporal motor control
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U2 - 10.1016/j.humov.2008.03.006
DO - 10.1016/j.humov.2008.03.006
M3 - Article
C2 - 18639360
AN - SCOPUS:54049149718
SN - 0167-9457
VL - 27
SP - 749
EP - 758
JO - Human Movement Science
JF - Human Movement Science
IS - 5
ER -