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- Alt Murphy, Margit, 1970, et al.
(författare)
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Perceptuo-motor planning during functional reaching after stroke.
- 2016
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Ingår i: 9th World Congress for Neurorehabilitation, WCNR-0340.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Objectives Healthy young people adjust their grasp position on an object depending on the future position of the object, a phenomenon described as the end-state comfort effect. This aspect of motor planning may be affected by stroke, especially in the presence of perceptual deficits. Thus, the aim of the study was to determine to what extent motor planning for reaches to different heights is affected by stroke. Methods Thirty-three adults (18 healthy, 15 chronic stroke with mild/moderate motor impairment) performed a functional goal-directed task, which included reaching, grasping and transporting a cylindrical object (a plunger) from a standard height to 4 different target heights, relative to the body. The relationship between grasp heights on the object shaft and the heights of target shelves was the primary outcome. This relationship, expressed as a slope, signifies the degree of perceptuo-motor coupling. An optoelectronic camera system recorded kinematics of the endpoint, arm and trunk. Sensorimotor impairment and perceptual deficits were measured with standardized validated clinical measures. Results A clear and strong linear relationship between grasp height and the target height was found in both groups. The mean values of the slopes for the affected and less-affected arm in stroke (-53.1 and -42.2) were not statistically different from healthy controls (-60.0). However, for the less-affected arm in the subgroup with visuo-perceptual impairments, the slopes were significantly lower than in healthy controls, indicating deficits in perceptuo-motor planning. Conclusions Results suggest that perceptuo-motor planning is relatively preserved in people with mild and moderate stroke, although visuo-perceptual impairment may influence this planning as indicated by the smaller end-state comfort effect in this subgroup of patients. In those without visuo-perceptual impairment, the system may preserve end-state comfort by incorporating compensations for the existing movement deficits.
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- Johansson, Gudrun M., 1963-, et al.
(författare)
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The added value of kinematic evaluation of the timed finger-to-nose test in persons post-stroke.
- 2017
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Ingår i: Journal of NeuroEngineering and Rehabilitation. - : Springer Science and Business Media LLC. - 1743-0003. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Upper limb coordination in persons post-stroke may be estimated by the commonly used Finger-to-Nose Test (FNT), which is also part of the Fugl-Meyer Assessment. The total movement time (TMT) is used as a clinical outcome measure, while kinematic evaluation also enables an objective quantification of movement quality and motor performance. Our aims were to kinematically characterize FNT performance in persons post-stroke and controls and to investigate the construct validity of the test in persons with varying levels of impairment post-stroke.METHODS: A three-dimensional motion capture system recorded body movements during performance of the FNT in 33 persons post-stroke who had mild or moderate upper limb motor impairments (Fugl-Meyer scores of 50-62 or 32-49, respectively), and 41 non-disabled controls. TMT and kinematic variables of the hand (pointing time, peak speed, time to peak speed, number of movement units, path ratio, and pointing accuracy), elbow/shoulder joints (range of motion, interjoint coordination), and scapular/trunk movement were calculated. Our analysis focused on the pointing phase (knee to nose movement of the FNT). Independent t or Mann-Whitney U tests and effect sizes were used to analyze group differences. Sub-group analyses based on movement time and stroke severity were performed. Within the stroke group, simple and multiple linear regression were used to identify relationships between TMT to kinematic variables.RESULTS: The stroke group had significant slower TMT (mean difference 2.6 s, d = 1.33) than the control group, and six other kinematic variables showed significant group differences. At matched speeds, the stroke group had lower accuracy and excessive scapular and trunk movements compared to controls. Pointing time and elbow flexion during the pointing phase were most related to stroke severity. For the stroke group, the number of movement units during the pointing phase showed the strongest association with the TMT, and explained 60% of the TMT variance.CONCLUSIONS: The timed FNT discriminates between persons with mild and moderate upper limb impairments. However, kinematic analysis to address construct validity highlights differences in pointing movement post-stroke that are not captured in the timed FNT.
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