http://nnr.sagepub.com/content/early/2015/10/27/1545968315613863.abstract?&
- Mindy F. Levin, PT, MSc, PhD1,2⇑
- Dario G. Liebermann, MSc, PhD3
- Yisrael Parmet, MSc, PhD4
- Sigal Berman, MSc, PhD4
- 1McGill University, Montreal, Quebec, Canada
- 2Center for Interdisciplinary Research in Rehabilitation (CRIR), Montreal, Quebec, Canada
- 3University of Tel Aviv, Tel Aviv, Israel
- 4Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Mindy F. Levin, School of Physical and Occupational Therapy, McGill University, 3654 Promenade Sir William Osler, Montreal, Quebec, H3G 1Y5, Canada. Email: mindy.levin@mcgill.ca
Abstract
Background. The extent to which
the upper-limb flexor synergy constrains or compensates for arm motor
impairment during reaching is
controversial. This synergy can be quantified with a
minimal marker set describing movements of the arm-plane.
Objectives. To determine whether and how (a)
upper-limb flexor synergy in patients with chronic stroke contributes
to reaching movements to different arm workspace locations
and (b) reaching deficits can be characterized by arm-plane motion.
Methods.
Sixteen post-stroke and 8 healthy control subjects made unrestrained
reaching movements to targets located in ipsilateral,
central, and contralateral arm workspaces.
Arm-plane, arm, and trunk motion, and their temporal and spatial
linkages were
analyzed.
Results. Individuals with
moderate/severe stroke used greater arm-plane movement and compensatory
trunk movement compared to those
with mild stroke and control subjects. Arm-plane
and trunk movements were more temporally coupled in stroke compared with
controls. Reaching accuracy was related to
different segment and joint combinations for each target and group:
arm-plane movement
in controls and mild stroke subjects, and trunk and
elbow movements in moderate/severe stroke subjects. Arm-plane movement
increased with time since stroke and when combined
with trunk rotation, discriminated between different subject groups for
reaching the central and contralateral targets.
Trunk movement and arm-plane angle during target reaches predicted the
subject
group.
Conclusions. The upper-limb flexor
synergy was used adaptively for reaching accuracy by patients with mild,
but not moderate/severe stroke.
The flexor synergy, as parameterized by the amount
of arm-plane motion, can be used by clinicians to identify levels of
motor
recovery in patients with stroke.
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