| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Brain, Vol. 119, No. 1, 281-293, 1996
© 1996 Oxford University Press
research-article |
Interjoint coordination during pointing movements is disrupted in spastic hemiparesis
Centre de Recherche, Institut de Réadaptation de Montréal, École de Réadaptation, Université de Montréal Montreal, Canada
Correspondence to:
Dr Mindy F. Levin, Centre de Recherche, Institut de Réadaptation de Montréal, 6300 av. Darlington, Montreal, Quebec, Canada H3S 2J4
Approaches to the rehabilitation of movement in spastic hemiparetic patients depend on knowledge of the underlying mechanisms of movement deficits. The goals of this study were to characterize end-point trajectories and interjoint coordination of arm pointing movements to different targets on a horizontal planar surface and to correlate disruptions in motor control in the affected arm of hemiparetic subjects with the level of spasticity and the degree of functional impairment measured clinically. Arm movements were studied in six normal and 10 hemiparetic subjects. Data from the affected arms of hemiparetic subjects were compared with those from their non-affected arms and to data from the arms of normal subjects. Subjects were seated in front of a horizontal surface adjusted to the height of the sternal notch with the trunk stabilized. They made planar arm reaching movements (20 and 40 cm) to four different targets located directly in front of them and in the ipsilateral and contralateral workspace. Kinematic data from the finger, wrist, elbow and shoulder were recorded with a three-dimensional optical tracking system. Results showed that movement amplitudes were lower and movement times were significantly prolonged in the affected arms. Although trajectories were marked by deviations from smooth straight lines and characterized by increased dispersion and segmentation, even those subjects with the most severe spasticity could reach into all parts of the workspace with both their affected and non-affected arms. This indicated that movement planning in terms of extrapersonal space was unaffected in these subjects. On the other hand, the interjoint coordination of movements made into or out of the typical extensor or flexor synergies was equally disrupted. These findings suggest a bi-level control organization of pointing movements in both normal and hemiparetic subjects: the level of trajectory planning in extrapersonal space and the level specifying interjoint coordination according to the trajectory plan. Deficits in motor performance in stroke patients may be associated with problems at the second control level. This implies some strategies for the rehabilitation of stroke patients with motor disorders. Treatment aimed at improving arm function should be oriented toward restoring the normal sensorimotor relationships between the joints. We also found that while clinical spasticity scores were correlated with some aspects of motor performance, they provided little information about the movement deficit itself.
motor control; stroke; spasticity; pointing movement; synergies
Received December 29, 1994. Revised July 20, 1995. Accepted August 23, 1995.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  T. M. Stoeckmann, K. J. Sullivan, and R. A. Scheidt Elastic, Viscous, and Mass Load Effects on Poststroke Muscle Recruitment and Co-contraction During Reaching: A Pilot Study Physical Therapy, July 1, 2009; 89(7): 665 - 678. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Casadio, P. Giannoni, P. Morasso, and V. Sanguineti A proof of concept study for the integration of robot therapy with physiotherapy in the treatment of stroke patients Clinical Rehabilitation, March 1, 2009; 23(3): 217 - 228. [Abstract] [PDF]
|
|
|
|
|
|
J. M Wagner, J. A Rhodes, and C. Patten Reproducibility and Minimal Detectable Change of Three-Dimensional Kinematic Analysis of Reaching Tasks in People With Hemiparesis After Stroke Physical Therapy, May 1, 2008; 88(5): 652 - 663. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K.-C. Lin, C.-Y. Wu, T.-H. Wei, C. Gung, C.-Y. Lee, and J.-S. Liu Effects of modified constraint-induced movement therapy on reach-to-grasp movements and functional performance after chronic stroke: a randomized controlled study Clinical Rehabilitation, December 1, 2007; 21(12): 1075 - 1086. [Abstract] [PDF]
|
|
|
|
 |
|
 C. E. Lang and J. A. Beebe Relating Movement Control at 9 Upper Extremity Segments to Loss of Hand Function in People with Chronic Hemiparesis Neurorehabil Neural Repair, May 1, 2007; 21(3): 279 - 291. [Abstract] [PDF]
|
|
|
|
|
|
D. S Reisman and J. P Scholz Deficits in Surface Force Production During Seated Reaching in People After Stroke Physical Therapy, March 1, 2007; 87(3): 326 - 336. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. M. Wagner, C. E. Lang, S. A. Sahrmann, Q. Hu, A. J. Bastian, D. F. Edwards, and A. W. Dromerick Relationships between Sensorimotor Impairments and Reaching Deficits in Acute Hemiparesis Neurorehabil Neural Repair, September 1, 2006; 20(3): 406 - 416. [Abstract] [PDF]
|
|
|
|
 |
|
 P. H. McCrea, J. J. Eng, and A. J. Hodgson Saturated Muscle Activation Contributes to Compensatory Reaching Strategies After Stroke J Neurophysiol, November 1, 2005; 94(5): 2999 - 3008. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J A Burne, V L Carleton, and N J O'Dwyer The spasticity paradox: movement disorder or disorder of resting limbs? J. Neurol. Neurosurg. Psychiatry, January 1, 2005; 76(1): 47 - 54. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Wenzelburger, F. Kopper, A. Frenzel, H. Stolze, S. Klebe, A. Brossmann, J. Kuhtz-Buschbeck, M. Golge, M. Illert, and G. Deuschl Hand coordination following capsular stroke Brain, January 1, 2005; 128(1): 64 - 74. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. M. Zackowski, A. W. Dromerick, S. A. Sahrmann, W. T. Thach, and A. J. Bastian How do strength, sensation, spasticity and joint individuation relate to the reaching deficits of people with chronic hemiparesis? Brain, May 1, 2004; 127(5): 1035 - 1046. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. F Levin, J. Desrosiers, D. Beauchemin, N. Bergeron, and A. Rochette Development and Validation of a Scale for Rating Motor Compensations Used for Reaching in Patients With Hemiparesis: The Reaching Performance Scale Physical Therapy, January 1, 2004; 84(1): 8 - 22. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. S. Reisman and J. P. Scholz Aspects of joint coordination are preserved during pointing in persons with post-stroke hemiparesis Brain, November 1, 2003; 126(11): 2510 - 2527. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Rohrer, S. Fasoli, H. I. Krebs, R. Hughes, B. Volpe, W. R. Frontera, J. Stein, and N. Hogan Movement Smoothness Changes during Stroke Recovery J. Neurosci., September 15, 2002; 22(18): 8297 - 8304. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. M. Michaelsen, A. Luta, A. Roby-Brami, and M. F. Levin Effect of Trunk Restraint on the Recovery of Reaching Movements in Hemiparetic Patients Stroke, August 1, 2001; 32(8): 1875 - 1883. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Whitall, S. M. Waller, K. H. C. Silver, and R. F. Macko Repetitive Bilateral Arm Training With Rhythmic Auditory Cueing Improves Motor Function in Chronic Hemiparetic Stroke Stroke, October 1, 2000; 31(10): 2390 - 2395. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. van Roon and W. Hulstijn Reciprocal tapping in spastic hemiparesis Clinical Rehabilitation, June 1, 2000; 14(6): 592 - 600. [Abstract] [PDF]
|
|
|
|
|
|
M. C. Cirstea and M. F. Levin Compensatory strategies for reaching in stroke Brain, May 1, 2000; 123(5): 940 - 953. [Abstract] [Full Text] [PDF]
|
|