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Control of reach extent with the paretic and nonparetic arms after unilateral sensorimotor stroke: kinematic differences based on side of brain damage

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Abstract

Scaling of reach kinematics to targets that vary in distance is indicative of the use of planning and feedback-based adjustments. The control of reach extent, however, has not been reported for the paretic arm after stroke. The purpose of this study was to determine whether individuals post-stroke utilized planning (scaling acceleration magnitude) and feedback-based adjustments (scaling acceleration duration) to reach to targets that varied in distance. Individuals with mild-to-moderate motor impairment after stroke and nondisabled adults reached with both arms to targets presented at three distances (8, 16, 24 cm). Kinematic data were used to determine scaling of peak acceleration magnitude and duration to target distance and compared between arms (control, nonparetic, paretic). Despite differences in the magnitude of movement variables, individuals post-stroke utilized both planning and feedback-based adjustments to meet the demands of the task with the nonparetic and paretic arms in a similar manner as controls. However, there was variability in the use of planning with the paretic arm, some individuals utilized planning while others did not. After right brain damage, differences in reach control related to the specialized role this hemisphere plays in endpoint control were found in both arms; no hemisphere-specific changes were found after left brain damage (LBD). The appearance of hemispheric-specific effects after right but not LBD were not due to age, degree of motor impairment, or time post-stroke, but, instead, may be related to relative differences in visual-motor processing ability, lesion characteristics, or interhemispheric inhibition changes between groups.

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Acknowledgments

The authors thank Lee Johnson and Bruce Larson for assistance with modifications to the virtual reality system and Liang-Ching Tsai for figure development. The virtual reality system used in this study was provided by Innovative Sports Training, Inc. Funding for this research was provided in part through a Mary McMillan Doctoral Scholarship and a Promotion of Doctoral Studies II Scholarship from the Foundation for Physical Therapy and a grant from the California Physical Therapy Fund.

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Authors and Affiliations

  1. Program in Physical Therapy, Department of Exercise Science, University of South Carolina, Columbia, SC, USA

    Jill Campbell Stewart

  2. Division of Biokinesiology and Physical Therapy, Ostrow School of Dentistry, University of Southern California, 1540 Alcazar Street, CHP 155, Los Angeles, CA, 90089-9006, USA

    James Gordon & Carolee J. Winstein

  3. Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA

    Carolee J. Winstein

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  1. Jill Campbell Stewart
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  2. James Gordon
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Correspondence to Carolee J. Winstein.

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Stewart, J.C., Gordon, J. & Winstein, C.J. Control of reach extent with the paretic and nonparetic arms after unilateral sensorimotor stroke: kinematic differences based on side of brain damage. Exp Brain Res 232, 2407–2419 (2014). https://doi.org/10.1007/s00221-014-3938-5

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  • DOI: https://doi.org/10.1007/s00221-014-3938-5

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