Kinematic upper extremity performance in people with near or fully recovered sensorimotor function after stroke

Area of Science:

• Neurorehabilitation
• Biomechanics
• Stroke Recovery

Background:

• Clinical scales like the Fugl-Meyer Assessment of Upper Extremity (FMA-UE) may not adequately assess motor function in high-functioning stroke survivors.
• Subtle upper extremity motor impairments can persist despite near-complete sensorimotor recovery after stroke.

Purpose of the Study:

• To characterize upper extremity movement kinematics in stroke survivors with high FMA-UE scores.
• To investigate the ceiling effect of the FMA-UE in detecting motor function deficits.

Main Methods:

• Cross-sectional study comparing stroke survivors (high FMA-UE scores) and healthy controls.
• Kinematic analysis of a standardized drinking task, measuring movement time, velocity, joint angles, and trunk displacement.
• Analysis of participants with submaximal (60-65) and maximal (66) FMA-UE scores at 3 months post-stroke.

Main Results:

• Stroke survivors with high FMA-UE scores demonstrated kinematic deficits in seven of eight variables compared to controls.
• Individuals with submaximal FMA-UE scores exhibited slower movements, reduced peak velocities, and increased trunk displacement.
• Those with maximal FMA-UE scores showed greater trunk displacement, arm abduction, and lower elbow peak angular velocity.

Conclusions:

• Individuals with substantial sensorimotor recovery post-stroke still exhibit measurable kinematic impairments.
• The FMA-UE may not be sensitive enough to detect these residual upper extremity motor control deficits in highly functioning stroke survivors.