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.
http://nnr.sagepub.com/content/30/7/635?etoc

1. Mindy F. Levin, PT, MSc, PhD1,2⇑
2. Dario G. Liebermann, MSc, PhD3
3. Yisrael Parmet, MSc, PhD4
4. Sigal Berman, MSc, PhD4

1. ¹McGill University, Montreal, Quebec, Canada
2. ²Center for Interdisciplinary Research in Rehabilitation (CRIR), Montreal, Quebec, Canada
3. ³University of Tel Aviv, Tel Aviv, Israel
4. ⁴Ben-Gurion University of the Negev, Beer-Sheva, Israel

1. 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.