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Perceptuo-motor planning during functional reaching after stroke.

Margit Alt Murphy1,2, Melanie C Baniña3,4, Mindy F Levin3,4

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Stroke survivors with visuo-perceptual impairments show a reduced end-state comfort effect, impacting movement planning. This highlights the crucial role of visual perception in goal-directed reaching for stroke rehabilitation.

Keywords:
Anticipatory motor planningArmEnd-state comfort effectKinematicsStrokeVisual perception

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Area of Science:

  • Neuroscience
  • Motor Control
  • Rehabilitation Science

Background:

  • The end-state comfort effect describes how movement planning is influenced by the desired final posture.
  • This effect, a form of perceptuo-motor coupling, is crucial for efficient goal-directed reaching.
  • Stroke-related deficits can significantly impair motor planning and execution.

Purpose of the Study:

  • To investigate the impact of visuo-perceptual and motor deficits, excluding neglect, on the end-state comfort effect in chronic stroke survivors.
  • To quantify the grasp-height effect, a measure of end-state comfort, in individuals post-stroke.
  • To differentiate the effects of visuo-perceptual versus sensorimotor impairments on movement planning.

Main Methods:

  • Thirty-four older adults (17 controls, 17 stroke survivors) performed a two-sequence reaching and moving task with a cylindrical object.
  • Participants reached from an initial position to various target platform heights.
  • Assessments included the Fugl-Meyer Assessment for motor impairment, the Motor-Free Visual Perception Test for visual-perceptual deficits, and kinematic analysis of arm and trunk movement.

Main Results:

  • The grasp-height effect was observed in all participants, indicating preserved end-state comfort planning.
  • Stroke survivors with visuo-perceptual impairments exhibited a diminished grasp-height effect compared to controls.
  • Stroke survivors with sensorimotor impairments alone (evidenced by altered kinematics) showed a grasp-height effect comparable to controls.

Conclusions:

  • Visuo-perceptual deficits significantly impact movement planning and the end-state comfort effect in individuals with stroke.
  • Altered kinematics due to sensorimotor impairments alone did not affect the grasp-height effect.
  • Findings suggest that targeted interventions for visuo-perceptual deficits may improve perceptuo-motor skills and motor recovery in stroke patients.