Perceptuo-motor planning during functional reaching after stroke.

• 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.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Annan medicin och hälsovetenskap (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Other Medical and Health Sciences (hsv//eng)

Nyckelord

perceptual motor performance

arm

kinematics

stroke

motor activity

Publikations- och innehållstyp

vet (ämneskategori)

kon (ämneskategori)