Related Experiment Video
Updated: May 9, 2026
05:28
Application of a Dual Upper Limb Task-Oriented Robotic System for the Functional Recovery of the Upper Limb in Stroke Patients
Published on: October 11, 2024
Understanding adaptive motor control of the paretic upper limb early poststroke: the EXPLICIT-stroke program
Joost van Kordelaar1, Erwin E H van Wegen, Rinske H M Nijland
11Department of Rehabilitation Medicine, MOVE Research Institute Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.
Neurorehabilitation and Neural Repair
|July 26, 2013
Summary
Stroke survivors learn to control arm movements early after stroke, improving shoulder and elbow coordination. However, full dissociation of these movements is not typically achieved within 26 weeks, indicating ongoing adaptation.
Area of Science:
- Neurorehabilitation
- Motor Recovery
- Biomechanics
Background:
- Significant upper limb motor recovery after stroke occurs within the initial 5 weeks.
- The specific motor learning processes during this early recovery phase remain largely uncharacterized.
Purpose of the Study:
- To test the hypothesis that stroke patients learn to control degrees of freedom in the paretic upper limb early post-stroke.
- To investigate the development of dissociated shoulder and elbow movements during reach-to-grasp tasks as a measure of motor learning.
Main Methods:
- Inclusion of 31 patients with first-ever ischemic stroke and 12 healthy controls.
- Repeated 3D kinematic measurements of trunk, shoulder, elbow, and wrist rotations during reach-to-grasp at multiple time points (14 to 189 days poststroke).
- Principal component analysis applied to analyze longitudinal changes in dissociated upper limb movements.
Main Results:
- A primary coordination pattern involving horizontal shoulder adduction and elbow extension was identified in both stroke patients and healthy subjects.
- The standard deviation of this pattern increased significantly in the first 5 weeks poststroke, indicating early motor adaptation.
- The rate of improvement in movement dissociation slowed considerably after 38 days poststroke, and patients generally showed less dissociation than healthy individuals by 26 weeks.
Conclusions:
- Motor control restitution, characterized by dissociated shoulder and elbow movements, predominantly occurs in the early stages after stroke.
- Despite early gains, most stroke survivors do not achieve fully dissociated upper limb movements by 26 weeks poststroke.
- Upper limb motor control following stroke appears to be a continuous adaptive process beyond the initial recovery phase.
