[Abstract+References] Movement Kinematics of the Ipsilesional Upper Extremity in Persons With Moderate or Mild Stroke

Background. An increasing number of studies have indicated that the ipsilesional arm may be impaired after stroke. There is, however, a lack of knowledge whether ipsilesional deficits influence movement performance during purposeful daily tasks.

Objective. The aim of this study was to investigate whether, and to what extent, movement impairments are present while performing an ipsilesional upper extremity task during the first 3 months after stroke.

Methods. Movement kinematics describing movement time, smoothness, velocity, strategy, and pattern were captured during a standardized drinking task in 40 persons with first-ever stroke and 20 controls. Kinematics were measured early and at 3 months poststroke, and sensorimotor impairment was assessed with Fugl-Meyer Assessment in stroke.

Results. Half of the ipsilesional kinematics showed significant deficits early after stroke compared to controls, and the stroke severity had a significant impact on the kinematics. Movements of the ipsilesional arm were slower, less smooth, demonstrated prolonged relative time in deceleration, and increased arm abduction during drinking. Kinematics improved over time and reached a level comparable with controls at 3 months, except for angular velocity of the elbow and deceleration time in reaching for those with more severe motor impairment.

Conclusions. This study demonstrates that movements of the ipsilesional arm, during a purposeful daily task, are impaired after stroke. These deficits are more prominent early after stroke and when the motor impairment is more severe. In clinical studies and praxis, the use of less-affected arm as a reference may underestimate the level of impairment and extent of recovery.

1. Persson HC, Parziali M, Danielsson A, Sunnerhagen KS. Outcome and upper extremity function within 72 hours after first occasion of stroke in an unselected population at a stroke unit. A part of the SALGOT study. BMC Neurol. 2012;12:162. Google Scholar CrossRef, Medline
2. Nakayama H, Jorgensen HS, Raaschou HO, Olsen TS. Recovery of upper extremity function in stroke patients: the Copenhagen Stroke Study. Arch Phys Med Rehabil. 1994;75:394398. Google Scholar CrossRef, Medline
3. Lawrence ES, Coshall C, Dundas R, . Estimates of the prevalence of acute stroke impairments and disability in a multiethnic population. Stroke. 2001;32:12791284. Google Scholar CrossRef, Medline
4. Jorgensen HS, Nakayama H, Raaschou HO, Olsen TS. Stroke. Neurologic and functional recovery the Copenhagen Stroke Study. Phys Med Rehabil Clin N Am. 1999;10:887906. Google Scholar Medline
5. Parker VM, Wade DT, Langton Hewer R. Loss of arm function after stroke: measurement, frequency, and recovery. Int Rehabil Med. 1986;8:6973. Google Scholar CrossRef, Medline
6. Shumway-Cook A, Woollacott MH. Motor Control: Translating Research Into Clinical Practice. 4th ed.Philadelphia, PA: Lippincott Williams & Wilkins; 2012. Google Scholar
7. Morris JH, Van Wijck F. Responses of the less affected arm to bilateral upper limb task training in early rehabilitation after stroke: a randomized controlled trial. Arch Phys Med Rehabil. 2012;93:11291137. Google Scholar CrossRef, Medline
8. Grefkes C, Fink GR. Reorganization of cerebral networks after stroke: new insights from neuroimaging with connectivity approaches. Brain. 2011;134(pt 5):12641276. Google Scholar CrossRef, Medline
9. Grefkes C, Fink GR. Connectivity-based approaches in stroke and recovery of function. Lancet Neurol. 2014;13:206216. Google Scholar CrossRef, Medline
10. Suzuki M, Omori Y, Sugimura S, . Predicting recovery of bilateral upper extremity muscle strength after stroke. J Rehabil Med. 2011;43:935943. Google Scholar CrossRef, Medline
11. Favre I, Zeffiro TA, Detante O, Krainik A, Hommel M, Jaillard A. Upper limb recovery after stroke is associated with ipsilesional primary motor cortical activity: a meta-analysis. Stroke. 2014;45:10771083. Google Scholar CrossRef, Medline
12. Pohl PS, Winstein CJ. Practice effects on the less-affected upper extremity after stroke. Arch Phys Med Rehabil. 1999;80:668675. Google Scholar CrossRef, Medline
13. McCombe Waller S, Whitall J. Fine motor control in adults with and without chronic hemiparesis: baseline comparison to nondisabled adults and effects of bilateral arm training. Arch Phys Med Rehabil. 2004;85:10761083. Google Scholar CrossRef, Medline
14. Sunderland A. Recovery of ipsilateral dexterity after stroke. Stroke. 2000;31:430433. Google Scholar CrossRef, Medline
15. Haaland KY, Delaney HD. Motor deficits after left or right hemisphere damage due to stroke or tumor. Neuropsychologia. 1981;19:1727. Google Scholar CrossRef, Medline
16. Kitsos GH, Hubbard IJ, Kitsos AR, Parsons MW. The ipsilesional upper limb can be affected following stroke. TheScientificWorldJournal. 2013;2013:684860. Google Scholar CrossRef, Medline
17. Metrot J, Froger J, Hauret I, Mottet D, van Dokkum L, Laffont I. Motor recovery of the ipsilesional upper limb in subacute stroke. Arch Phys Med Rehabil. 2013;94:22832290. Google Scholar CrossRef, Medline
18. Jones RD, Donaldson IM, Parkin PJ. Impairment and recovery of ipsilateral sensory-motor function following unilateral cerebral infarction. Brain. 1989;112(pt 1):113132. Google Scholar CrossRef, Medline
19. Desrosiers J, Bourbonnais D, Bravo G, Roy PM, Guay M. Performance of the “unaffected” upper extremity of elderly stroke patients. Stroke. 1996;27:15641570. Google Scholar CrossRef, Medline
20. Sunderland A, Bowers MP, Sluman SM, Wilcock DJ, Ardron ME. Impaired dexterity of the ipsilateral hand after stroke and the relationship to cognitive deficit. Stroke. 1999;30:949955. Google Scholar CrossRef, Medline
21. Wetter S, Poole JL, Haaland KY. Functional implications of ipsilesional motor deficits after unilateral stroke. Arch Phys Med Rehabil. 2005;86:776781. Google Scholar CrossRef, Medline
22. Noskin O, Krakauer JW, Lazar RM, . Ipsilateral motor dysfunction from unilateral stroke: implications for the functional neuroanatomy of hemiparesis. J Neurol Neurosurg Psychiatry. 2008;79:401406. Google Scholar CrossRef, Medline
23. Alt Murphy M, Häger CK. Kinematic analysis of the upper extremity after stroke—how far have we reached and what have we grasped? Phys Ther Rev. 2015;20:137155. Google Scholar CrossRef
24. Alt Murphy M, Willen C, Sunnerhagen KS. Kinematic variables quantifying upper-extremity performance after stroke during reaching and drinking from a glass. Neurorehabil Neural Repair. 2011;25:7180. Google Scholar Link
25. van Dokkum L, Hauret I, Mottet D, Froger J, Metrot J, Laffont I. The contribution of kinematics in the assessment of upper limb motor recovery early after stroke. Neurorehabil Neural Repair. 2014;28:412. Google Scholar Link
26. Buma F, Kwakkel G, Ramsey N. Understanding upper limb recovery after stroke. Restor Neurol Neurosci. 2013;31:707722. Google Scholar Medline
27. Kitago T, Liang J, Huang VS, . Improvement after constraint-induced movement therapy: recovery of normal motor control or task-specific compensation? Neurorehabil Neural Repair. 2013;27:99109. Google Scholar Link
28. van Vliet PM, Sheridan MR. Coordination between reaching and grasping in patients with hemiparesis and healthy subjects. Arch Phys Med Rehabil. 2007;88:13251331. Google Scholar CrossRef, Medline
29. Aprile I, Rabuffetti M, Padua L, Di Sipio E, Simbolotti C, Ferrarin M. Kinematic analysis of the upper limb motor strategies in stroke patients as a tool towards advanced neurorehabilitation strategies: a preliminary study. BioMed Res Int. 2014;2014:636123. Google Scholar CrossRef, Medline
30. Nakamura T, Abreu BC, Patterson RM, Buford WLJr, Ottenbacher KJ. Upper-limb kinematics of the presumed-to-be-unaffected side after brain injury. Am J Occup Ther. 2008;62:4650. Google Scholar CrossRef, Medline
31. Ketcham CJ, Rodriguez TM, Zihlman KA. Targeted aiming movements are compromised in nonaffected limb of persons with stroke. Neurorehabil Neural Repair. 2007;21:388397. Google Scholar Link
32. Schaefer SY, Haaland KY, Sainburg RL. Hemispheric specialization and functional impact of ipsilesional deficits in movement coordination and accuracy. Neuropsychologia. 2009;47:29532966. Google ScholarCrossRef, Medline
33. Nowak DA, Grefkes C, Dafotakis M, Kust J, Karbe H, Fink GR. Dexterity is impaired at both hands following unilateral subcortical middle cerebral artery stroke. Eur J Neurosci. 2007;25:31733184. Google Scholar CrossRef, Medline
34. Jeannerod M, Paulignan Y, Weiss P. Grasping an object: one movement, several components. Novartis Found Symp. 1998;218:516. Google Scholar Medline
35. Wu C, Trombly CA, Lin K, Tickle-Degnen L. Effects of object affordances on reaching performance in persons with and without cerebrovascular accident. Am J Occup Ther. 1998;52:447456. Google ScholarCrossRef, Medline
36. Alt Murphy M, Persson HC, Danielsson A, Broeren J, Lundgren-Nilsson A, Sunnerhagen KS. SALGOT—Stroke Arm Longitudinal study at the University of Gothenburg, prospective cohort study protocol. BMC Neurol. 2011;11:56. Google Scholar CrossRef, Medline
37. Alt Murphy M, Sunnerhagen KS, Johnels B, Willen C. Three-dimensional kinematic motion analysis of a daily activity drinking from a glass: a pilot study. J Neuroeng Rehabil. 2006;3:18. Google ScholarCrossRef, Medline
38. Alt Murphy M, Willen C, Sunnerhagen KS. Movement kinematics during a drinking task are associated with the activity capacity level after stroke. Neurorehabil Neural Repair. 2012;26:11061115. Google Scholar Link
39. Alt Murphy M, Willen C, Sunnerhagen KS. Responsiveness of upper extremity kinematic measures and clinical improvement during the first three months after stroke. Neurorehabil Neural Repair. 2013;27:844853. Google Scholar Link
40. Patterson TS, Bishop MD, McGuirk TE, Sethi A, Richards LG. Reliability of upper extremity kinematics while performing different tasks in individuals with stroke. J Mot Behav. 2011;43:121130. Google ScholarCrossRef, Medline
41. Platz T, Prass K, Denzler P, Bock S, Mauritz KH. Testing a motor performance series and a kinematic motion analysis as measures of performance in high-functioning stroke patients: reliability, validity, and responsiveness to therapeutic intervention. Arch Phys Med Rehabil. 1999;80:270277. Google Scholar CrossRef, Medline
42. Subramanian SK, Yamanaka J, Chilingaryan G, Levin MF. Validity of movement pattern kinematics as measures of arm motor impairment poststroke. Stroke. 2010;41:23032308. Google Scholar CrossRef, Medline
43. Nijenhuis SM, Prange GB, Stienen AHA, Buurke JH, Rietman JS. Direct effect of a dynamic wrist and hand orthosis on reach and grasp kinematics in chronic stroke. Paper presented at: IEEE International Conference on Rehabilitation Robotics; Singapore; August 11-14, 2015: 404409.
44. Kamper DG, McKenna-Cole AN, Kahn LE, Reinkensmeyer DJ. Alterations in reaching after stroke and their relation to movement direction and impairment severity. Arch Phys Med Rehabil. 2002;83:702707. Google Scholar CrossRef, Medline
45. Fugl-Meyer AR, Jaasko L, Leyman I, Olsson S, Steglind S. The post-stroke hemiplegic patient. 1. A method for evaluation of physical performance. Scand J Rehabil Med. 1975;7:1331. Google Scholar Medline
46. Fugl-Meyer AR. Post-stroke hemiplegia assessment of physical properties. Scand J Rehabil Med. 1980;2(7):8593. Google Scholar
47. Duncan PW, Propst M, Nelson SG. Reliability of the Fugl-Meyer assessment of sensorimotor recovery following cerebrovascular accident. Phys Ther. 1983;63:16061610. Google Scholar CrossRef, Medline
48. Persson HC, Alt Murphy M, Danielsson A, Lundgren-Nilsson A, Sunnerhagen KS. A cohort study investigating a simple, early assessment to predict upper extremity function after stroke—a part of the SALGOT study. BMC Neurol. 2015;15:92. Google Scholar CrossRef, Medline
49. Bohannon RW, Smith MB. Interrater reliability of a modified Ashworth scale of muscle spasticity. Phys Ther. 1987;67:206207. Google Scholar CrossRef, Medline
50. Adams HPJr, Bendixen BH, Kappelle LJ, . Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment. Stroke. 1993;24:3541. Google Scholar CrossRef, Medline
51. Bamford J, Sandercock P, Dennis M, Burn J, Warlow C. Classification and natural history of clinically identifiable subtypes of cerebral infarction. Lancet. 1991;337:15211526. Google Scholar CrossRef, Medline
52. Pallant J. SPSS Survival Manual: A Step by Step Guide to Data Analysis Using SPSS for Windows (Version 15). Buckingham, England: Open University Press; 2007. Google Scholar
53. Kwakkel G, Kollen B, Lindeman E. Understanding the pattern of functional recovery after stroke: facts and theories. Restor Neurol Neurosci. 2004;22:281299. Google Scholar Medline
54. Buma FE, van Kordelaar J, Raemaekers M, van Wegen EE, Ramsey NF, Kwakkel G. Brain activation is related to smoothness of upper limb movements after stroke. Exp Brain Res. 2016;234:20772089. Google Scholar CrossRef, Medline
55. Sainburg RL, Duff SV. Does motor lateralization have implications for stroke rehabilitation? J Rehabil Res Dev. 2006;43:311322. Google Scholar CrossRef, Medline
56. Pohl PS, Luchies CW, Stoker-Yates J, Duncan PW. Upper extremity control in adults post stroke with mild residual impairment. Neurorehabil Neural Repair. 2000;14:3341. Google Scholar Link
57. Schaefer SY, Haaland KY, Sainburg RL. Ipsilesional motor deficits following stroke reflect hemispheric specializations for movement control. Brain. 2007;130(pt 8):21462158. Google Scholar CrossRef, Medline
58. Mani S, Mutha PK, Przybyla A, Haaland KY, Good DC, Sainburg RL. Contralesional motor deficits after unilateral stroke reflect hemisphere-specific control mechanisms. Brain. 2013;136(pt 4):12881303. Google Scholar CrossRef, Medline
59. McCrea PH, Eng JJ, Hodgson AJ. Biomechanics of reaching: clinical implications for individuals with acquired brain injury. Disabil Rehabil. 2002;24:534541. Google Scholar CrossRef, Medline

Source: Movement Kinematics of the Ipsilesional Upper Extremity in Persons With Moderate or Mild Stroke – Jan 20, 2017

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