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Published on: May 2, 2021
Kinematic Manifestation of Arm-Trunk Performance during Symmetric Bilateral Reaching After Stroke: Within vs. Beyond
Hui-Ing Ma1, Keh-Chung Lin, Fu-Han Hsieh
1From the Department of Occupational Therapy and Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan (H-IM); School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei (K-CL); Division of Occupational Therapy, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei (K-CL); Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, and Healthy Aging Research Center (F-HH, C-YW), Graduate Institute of Early Intervention, College of Medicine (C-LC), and School of Medicine, College of Medicine (SFT), Chang Gung University, Taoyuan; and Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Taoyuan, Taiwan (C-LC, SFT, C-YW).
Objective:
The aim of this study was to examine the effect of target distance (within vs. beyond arm's length) on arm and trunk movements during symmetric bilateral reaching in patients with stroke.
Design:
Eighteen stroke patients and 18 age-matched control participants reached bilaterally to press desk bells placed at 90% and 125% of arm's length. The kinematics of paretic arm and trunk movements and trunk contribution slopes were measured in the start, mid, and end phases of reaching.
Results:
Target distance significantly affected arm (shoulder flexion and abduction, elbow extension) and trunk (flexion, rotation, and lateral shift) movements in patients with stroke. Significant group differences were also found in trunk contribution slopes in the start and mid phases of reaching to targets beyond arm's length.
Conclusions:
Bilateral reaching for targets beyond arm's length may increase shoulder flexion, shoulder abduction, elbow extension, and trunk flexion, but it may also induce unsymmetric trunk rotation and lateral shift to the paretic side, as well as early and excessive trunk contributions in patients with stroke. The findings suggest that for beyond-arm-length reaching, therapists may restrain the trunk until the end phase of reaching and prevent trunk rotation and lateral shift to the paretic side.
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