Influence of target uncertainty on reaching movements while standing in stroke

Stroke individuals frequently have balance problems and impaired arm movements that affect their daily activities. We investigated the influence of target uncertainty and the side of the brain lesion on the performance of arm movements and postural adjustments during reaching in a standing position by stroke individuals. Participants stood on force plates and reached a target displayed on the center of a monitor screen under conditions differentiated by the prior knowledge of the target location at the beginning of the movement. Individuals who had a stroke in the right side of the brain performed the tasks with the ipsilesional, right upper limb while the individuals with a left stroke performed with the ipsilesional, left upper limb. Healthy individuals performed with right and left limbs, which data were later averaged for statistical analysis. Kinematic analysis of the arm and lower limb joints and displacements of the center of pressure of each lower limb were compared between target conditions and groups. Stroke individuals showed larger center of pressure displacements of the contralesional compared to the ipsilesional limb while these displacements were symmetrical between lower limbs for the healthy individuals, regardless of the target condition. The target uncertainty affected both the characteristics of the arm movements and postural adjustments before movement onset. Right stroke individuals used more ankle joint movements under the uncertain compared to the certain condition. The uncertainty in target location affects the arm reaching in upright standing, but the effects depend on the side of the brain lesion.