http://nnr.sagepub.com/content/26/4/362.abstract?etoc
Abstract
Background. Although slow and insufficient
muscle activation is a hallmark of hemiparesis poststroke, movement
speed is rarely emphasized
during upper-extremity rehabilitation. Moving
faster may increase the intensity of task-specific training, but
positive and/or
negative effects on paretic-limb movement quality
are unknown. Objective. To determine whether moving quickly instead of at a preferred speed either enhances or impairs paretic-limb task performance
after stroke. Methods. A total of 16
people with poststroke hemiparesis and 11 healthy controls performed
reach–grasp–lift movements at their preferred
speed and as fast as possible, using palmar and
3-finger grip types. The authors measured durations of the reach and
grasp
phases, straightness of the reach path, thumb–index
finger separation (aperture), efficiency of finger movement, and grip
force. Results. Reach and grasp phase
durations decreased in the fast condition in both groups, showing that
participants were able to move
more quickly when asked. When moving fast, the
hemiparetic group had reach durations equal to those of healthy controls
moving
at their preferred speed. Movement quality also
improved. Reach paths were straighter, and peak apertures were greater
in
both groups in the fast condition. The group with
hemiparesis also showed improved efficiency of finger movement.
Differences
in peak grip force across speed conditions did not
reach significance. Conclusions. People with hemiparesis who
can perform reach–grasp–lift movements with a 3-finger grip can move
faster than they choose
to, and when they do, movement quality improves.
Simple instructions to move faster could be a cost-free and effective
means
of increasing rehabilitation intensity after
stroke.
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