Coordination deficits on the ipsilesional side after unilateral stroke: the effect of practice on nonisodirectional...

Previous studies have identified motor deficits on the ipsilesional side of patients recovering from a cerebro-vascular accident (CVA), including deficits in interlimb coordination. In the present study, unilateral stroke patients and a control group of healthy age-matched controls performed nonisodirectional coordination of the ipsilateral limbs across two days of practice with feedback. Findings revealed that control subjects were already quite successful at initiation of practice but further improved the coordination pattern across both days. The group of CVA patients also showed some improvement but problems with coordination of the ipsilateral limb segments persisted across practice. Variability in both timing and amplitude of both limb segments did improve with practice in both groups but these measures remained significantly higher in the CVA patients. Even though isodirectional and nonisodirectional coordination of the ipsilateral limb segments are normally considered to be part of the intrinsic motor repertoire, the present study suggests that nonisodirectional ipsilesional limb coordination poses considerable difficulties for CVA patients that are not easily overcome with feedback-assisted practice.