Article

After stroke, movement patterns of the upper limb (UL) during functional arm
reaching change to accommodate altered constraints. These compensatory movement
control strategies do not, however, have a one-to-one mapping with posttraining
outcomes. In this study, we quantify arm movement control strategies in
unilateral and bilateral reaching tasks using induced position analysis. In
addition, we assess how those strategies are associated with UL residual
impairments and with functional improvement after a specific bilateral arm
training intervention. Twelve individuals with chronic stroke were measured while
reaching to a box as part of their pre- and posttesting assessments. Other
measurements included the Fugl-Meyer Upper Extremity Assessment (FM), Modified
Wolf Motor Function Test (WT), and the University of Maryland Arm Questionnaire
for Stroke (UMAQS). We identified arm control strategies that did not differ
between unilateral and bilateral tasks but did differ by FM impairment level and
by predicted gains in WT but not UMAQS. Increased shoulder relative to elbow
moment contribution was associated with less impairment and greater gains of
speed in functional tasks. These results suggest that one goal of training to
achieve better outcomes may be to decrease the abnormal coupling of the shoulder
and elbow.

Langue : ANGLAIS