Article

The velocity of reaching movements is often reduced in patients with
stroke-related hemiparesis; however, they are able to voluntarily increase
paretic hand velocity. Previous studies have proposed that faster speed improves
movement quality. OBJECTIVE: To investigate the combined effects of reaching
distance and speed instruction on trunk and paretic upper-limb coordination. The
hypothesis was that increased speed would reduce elbow extension and increase
compensatory trunk movement. METHODS: A single session study in which reaching
kinematics were recorded in a group of 14 patients with spastic hemiparesis. A
3-dimensional motion analysis system was used to track the trajectories of 5
reflective markers fixed on the finger, wrist, elbow, acromion, and sternum. The
reaching movements were performed to 2 targets at 60% and 90% arm length,
respectively, at preferred and maximum velocity. The experiment was repeated with
the trunk restrained by a strap. RESULTS: All the patients were able to
voluntarily increase reaching velocity. In the trunk free, faster speed
condition, elbow extension velocity increased but elbow extension amplitude
decreased and trunk movement increased. In the trunk restraint condition, elbow
extension amplitude did not decrease with faster speed. Seven patients scaled
elbow extension and elbow extension velocity as a function of reach distance, the
other 7 mainly increased trunk compensation with increased task constraints.
There were no clear clinical characteristics that could explain this difference.
CONCLUSIONS: Faster speed may encourage some patients to use compensation.
Individual indications for therapy could be based on a quantitative analysis of
reaching coordination.
CI - (c) The Author(s) 2015.

Langue : ANGLAIS