Exploiting interlimb coupling to improve paretic arm reaching performance in people with chronic stroke.

Abstract:

OBJECTIVE:To determine whether paretic arm reaching performance is improved in bilateral compared with unilateral conditions. DESIGN:Cohort study. SETTING:University human performance laboratory. PARTICIPANTS:Thirty-two subjects with chronic stroke (57+/-14y; on Fugl-Meyer Assessment arm score, 37+/-14). INTERVENTION:Unilateral and bilateral reaching. Bilateral tasks included varying levels of weight on the nonparetic hand. MAIN OUTCOME MEASURES:An electromagnetic tracking system recorded hand peak acceleration, velocity, and movement time. A 2-way repeated-measures analysis of variance and Tukey-adjusted pairwise comparisons were used to analyze the results (alpha=.05). RESULTS:Paretic differed significantly from nonparetic peak acceleration and velocity in unilateral reaching but not bilateral reaching. Within limbs, the paretic arm attained a higher peak acceleration (P<.001) and velocity (P=.03) in the bilateral compared with the unilateral task, but movement time was unchanged between tasks. Nonparetic peak acceleration was higher (P=.015), velocity was unchanged, and movement time increased (P=.005) in the bilateral compared with the unilateral task. The addition of a weight to the nonparetic arm during bilateral reaching did not result in further improvement in paretic arm performance. CONCLUSIONS:Interlimb coupling effects during bilateral reaching are retained even after chronic stroke and can be used to produce an immediate improvement in paretic arm reaching performance.

journal_name

Arch Phys Med Rehabil

authors

Harris-Love ML,McCombe Waller S,Whitall J

doi

10.1016/j.apmr.2005.05.006

subject

Has Abstract

pub_date

2005-11-01 00:00:00

pages

2131-7

issue

11

eissn

0003-9993

issn

1532-821X

pii

S0003-9993(05)00481-8

journal_volume

86

pub_type

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