Deans' stroke musings: Compensatory Versus Noncompensatory Shoulder Movements Used for Reaching in Stroke

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Tuesday, July 12, 2016

Compensatory Versus Noncompensatory Shoulder Movements Used for Reaching in Stroke

Once again pretty much useless research. A great stroke association president would be contacting these researchers to get useful solutions from each research trial rather than just posing a question and leaving the survivor hanging with no solution in sight. My reaching ability is pretty much non-existent, the first problem is the spasticity causing the arm to be hard to even lift to start the process, then the spasticity preventing the straightening of the arm, then no opening of the hand. I see absolutely nothing here than would help me.

Compensatory Versus Noncompensatory Shoulder Movements Used for Reaching in Stroke

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, PT, MSc, PhD, 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.