Person-specific changes in motor performance accompany upper extremity functional gains after stroke

J Appl Biomech. 2012 Jul;28(3):304-16. doi: 10.1123/jab.28.3.304. Epub 2011 Oct 4.

Abstract

In animal models, hundreds of repetitions of upper extremity (UE) task practice promote neural adaptation and functional gain. Recently, we demonstrated improved UE function following a similar intervention for people after stroke. In this secondary analysis, computerized measures of UE task performance were used to identify movement parameters that changed as function improved. Ten people with chronic poststroke hemiparesis participated in high-repetition UE task-specific training 3 times per week for 6 weeks. Before and after training, we assessed UE function with the Action Research Arm Test (ARAT), and evaluated motor performance using computerized motion capture during a reach-grasp-transport-release task. Movement parameters included the duration of each movement phase, trunk excursion, peak aperture, aperture path ratio, and peak grip force. Group results showed an improvement in ARAT scores (p = .003). Although each individual changed significantly on at least one movement parameter, across the group there were no changes in any movement parameter that reached or approached significance. Changes on the ARAT were not closely related to changes in movement parameters. Since aspects of motor performance that contribute to functional change vary across individuals, an individualized approach to upper extremity motion analysis appears warranted.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Physiological
  • Adult
  • Aged
  • Aged, 80 and over
  • Exercise Therapy / methods
  • Female
  • Humans
  • Male
  • Middle Aged
  • Paresis / etiology
  • Paresis / physiopathology*
  • Paresis / rehabilitation*
  • Psychomotor Performance*
  • Recovery of Function
  • Stroke / complications
  • Stroke / physiopathology*
  • Stroke Rehabilitation*
  • Treatment Outcome
  • Upper Extremity / physiopathology*