Assessing impaired arm use and learned bias after stroke using unimanual and bimanual steering tasks

Learned nonuse is often seen in stroke survivors with hemiparesis. In these cases, stroke survivors exhibit a bias for using the less impaired arm on daily living tasks despite latent functionality as measured by clinical motor function. We used the TheraDrive system, a low-cost, stroke rehabilitation system using commercial force-feedback steering wheels along with unimanual and bimanual steering tasks, to quantify the motor impairment, arm use bias and the effect of functioning levels on tracking performance. We present the methodology and tracking results that support the use of steering tasks to detect the presence of motor impairment in the contralateral side of the brain injury, the presence of learned nonuse, the relationship between level of functionality (low-to-medium versus high stroke) and these measures and the effect of handedness and side of injury after stroke.