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Chronic Stroke Survivors Improve Reaching Accuracy by Reducing Movement Variability at the Trained Movement Speed.

Abstract：

BACKGROUND:Recovery from stroke is often said to have "plateaued" after 6 to 12 months. Yet training can still improve performance even in the chronic phase. Here we investigate the biomechanics of accuracy improvements during a reaching task and test whether they are affected by the speed at which movements are practiced. METHOD:We trained 36 chronic stroke survivors (57.5 years, SD ± 11.5; 10 females) over 4 consecutive days to improve endpoint accuracy in an arm-reaching task (420 repetitions/day). Half of the group trained using fast movements and the other half slow movements. The trunk was constrained allowing only shoulder and elbow movement for task performance. RESULTS:Before training, movements were variable, tended to undershoot the target, and terminated in contralateral workspace (flexion bias). Both groups improved movement accuracy by reducing trial-to-trial variability; however, change in endpoint bias (systematic error) was not significant. Improvements were greatest at the trained movement speed and generalized to other speeds in the fast training group. Small but significant improvements were observed in clinical measures in the fast training group. CONCLUSIONS:The reduction in trial-to-trial variability without an alteration to endpoint bias suggests that improvements are achieved by better control over motor commands within the existing repertoire. Thus, 4 days' training allows stroke survivors to improve movements that they can already make. Whether new movement patterns can be acquired in the chronic phase will need to be tested in longer term studies. We recommend that training needs to be performed at slow and fast movement speeds to enhance generalization.

journal_name

Neurorehabil Neural Repair

journal_title

Neurorehabilitation and neural repair

authors

Hammerbeck U,Yousif N,Hoad D,Greenwood R,Diedrichsen J,Rothwell JC

doi

10.1177/1545968317693112

subject

Has Abstract

pub_date

2017-06-01 00:00:00

pages

499-508

issue

6

eissn

1545-9683

issn

1552-6844

journal_volume

31

pub_type

杂志文章,随机对照试验

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