Kinematic descriptions of upper limb function using simulated tasks in activities of daily living after stroke

I fail to see how 'assessments' get survivors recovered! With 100% recovery protocols, the result would be recovery! No assessment needed.

 Kinematic descriptions of upper limb function using simulated tasks in activities of daily living after stroke

Yen-Wei Chen a, b , Wan-Wen Liao a , Chia-Ling Chen c, d , Ching-Yi Wu a, b, d, * a Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan b Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan c Graduate Institute of Early Intervention, College of Medicine, Chang Gung University, Taoyuan, Taiwan d Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, Taiwan A R T I C L E INFO Keywords: Stroke Kinematics Upper extremity Activities of daily living Motor control Variability 

ABSTRACT 

Assessment of upper limb function poststroke is critical for clinical management and determining the efficacy of interventions. We designed a unilateral upper limb task to simulate activities of daily living to examine how chronic stroke survivors manage reaching, grasping and handling skills simultaneously to perform the functional task using kinematic analysis. The aim of the study was to compare the motor strategies for performing a functional task between paretic and non- paretic arms. Sixteen chronic stroke survivors were instructed to control an ergonomic spoon to transfer liquid from a large bowl to a small bowl using paretic or nonparetic arm. Kinematic data were recorded using a Vicon motion capture system. Outcome measures included movement duration, relative timing, path length, joint excursions, and trial-to-trial variability. Results showed that movement duration, spoon path length, and trunk path length increased significantly when participants used paretic arm to perform the task. Participants tended to reduce shoulder and elbow excursions, and increase trunk excursions to perform the task with paretic arm and altered the relative timing of the task. Although participants used different motor strategies to perform the task with their paretic arms, we did not find the significant differences in trial-to trial variability of joint excursions between paretic and nonparetic arms. The results revealed differ- ences in temporal and spatial aspects of motor strategies between paretic and nonparetic arms. Clinicians should explore the underlying causes of pathological movement patterns and facilitate preferred movement patterns of paretic arm.