Article

OBJECTIVE: To establish the time course of recovery regarding smoothness of upper
limb movements in the first 6 months poststroke. DESIGN: Cohort study with
3-dimensional kinematic measurements in weeks 1, 2, 3, 4, 5, 8, 12, and 26
poststroke. SETTING: Onsite 3-dimensional kinematic measurements in stroke units,
rehabilitation centers, nursing homes, and patients' homes. PARTICIPANTS:
Patients (N=44; 19 women, 25 men; mean age +/- SD, 58+/-12y) with a first-ever
unilateral ischemic stroke and incomplete upper limb paresis (27 left sided, 17
right sided) were included. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES:
In each measurement, an electromagnetic motion tracker acquired hand and finger
trajectories during a reach-to-grasp task. Movement duration was determined, and
smoothness of hand transport and grasp aperture was quantified by normalized
jerk. With the use of random coefficient analysis, the effect of progress of time
on smoothness of hand transport and grasp aperture was investigated. RESULTS:
During the first 5 weeks poststroke, there was a significant contribution of
progress of time to reductions in movement duration and normalized jerk of hand
transport and grasp aperture (P<.01). CONCLUSIONS: The present longitudinal
3-dimensional kinematic study showed that smoothness of paretic upper limb
movements improves in the first 8 weeks poststroke. This improvement suggests
that motor control normalizes in the first 8 weeks poststroke and can be mostly
explained by spontaneous neurologic recovery that occurs typically in the first
weeks poststroke. Future 3-dimensional kinematic studies should investigate
whether therapies starting early after stroke can improve the quality of motor
control beyond spontaneous neurologic recovery.
CI - Copyright (c) 2014 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS