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Rhythmic arm movements are less affected than discrete ones after a stroke

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Abstract

Recent reports indicate that rhythmic and discrete upper-limb movements are two different motor primitives which recruit, at least partially, distinct neural circuitries. In particular, rhythmic movements recruit a smaller cortical network than discrete movements. The goal of this paper is to compare the levels of disability in performing rhythmic and discrete movements after a stroke. More precisely, we tested the hypothesis that rhythmic movements should be less affected than discrete ones, because they recruit neural circuitries that are less likely to be damaged by the stroke. Eleven stroke patients and eleven age-matched control subjects performed discrete and rhythmic movements using an end-effector robot (REAplan). The rhythmic movement condition was performed with and without visual targets to further decrease cortical recruitment. Movement kinematics was analyzed through specific metrics, capturing the degree of smoothness and harmonicity. We reported three main observations: (1) the movement smoothness of the paretic arm was more severely degraded for discrete movements than rhythmic movements; (2) most of the patients performed rhythmic movements with a lower harmonicity than controls; and (3) visually guided rhythmic movements were more altered than non-visually guided rhythmic movements. These results suggest a hierarchy in the levels of impairment: Discrete movements are more affected than rhythmic ones, which are more affected if they are visually guided. These results are a new illustration that discrete and rhythmic movements are two fundamental primitives in upper-limb movements. Moreover, this hierarchy of impairment opens new post-stroke rehabilitation perspectives.

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Acknowledgments

The authors would like to thank Catherine Rasse for her support with the statistics, the subjects for their availability to participate in the study and the physiotherapists who helped in recruitment of the patients.

Funding

This work was supported by the Belgian F.R.S.-FNRS (FRIA grant awarded to PL, Fonds pour la Recherche dans l’Industrie et l’Agriculture) and by the “Fondation van Goethem Brichant.”

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Authors and Affiliations

  1. Institute of Mechanics, Materials and Civil Engineering, Université catholique de Louvain, Place du Levant 2, 1348, Louvain-la-Neuve, Belgium

    Patricia Leconte & Renaud Ronsse

  2. Institute of Experimental and Clinical Research, Université catholique de Louvain, Tour Pasteur - Avenue Mounier 53, 1200, Brussels, Belgium

    Gaëtan Stoquart & Thierry Lejeune

  3. Institute of Neuroscience, Université catholique de Louvain, Tour Pasteur - Avenue Mounier 53, 1200, Brussels, Belgium

    Jean-Jacques Orban de Xivry & Renaud Ronsse

  4. Institute of Information and Communication Technologies, Electronics and Applied Mathematics, Université catholique de Louvain, Avenue Georges Lemaître 4, 1348, Louvain-la-Neuve, Belgium

    Jean-Jacques Orban de Xivry

  5. Physical Medicine and Rehabilitation Department, Cliniques universitaires Saint-Luc, Université catholique de Louvain, Brussels, 1200, Belgium

    Gaëtan Stoquart & Thierry Lejeune

  6. Louvain Bionics, Université catholique de Louvain, 1348, Louvain-la-Neuve, Belgium

    Patricia Leconte, Gaëtan Stoquart, Thierry Lejeune & Renaud Ronsse

  7. Department of Kinesiology, Movement Control and Neuroplasticity Research Group, KU Leuven, 3001, Heverlee, Belgium

    Jean-Jacques Orban de Xivry

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  1. Patricia Leconte
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Correspondence to Renaud Ronsse.

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Glossary

D-T

Discrete task with small targets

FMA-UE

Fugl-Meyer assessment of the upper extremity

H

Harmonicity index

ID

Index of difficulty

PEAK

Number of peaks in the velocity profile

LDJ

Logarithmic dimensionless jerk

R-T

Rhythmic task with large targets

R-NT

Rhythmic task without targets

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Leconte, P., Orban de Xivry, JJ., Stoquart, G. et al. Rhythmic arm movements are less affected than discrete ones after a stroke. Exp Brain Res 234, 1403–1417 (2016). https://doi.org/10.1007/s00221-015-4543-y

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