Related Experiment Video
Updated: Sep 19, 2025
The Impact of Motor Task Conditions on Goal-Directed Arm Reaching Kinematics and Trunk Compensation in Chronic Stroke Survivors
Published on: May 2, 2021
Trial-By-Trial Variation In Upper Extremity Movement Smoothness After Acute Stroke Relates To Clinical Assessments
Sarah K Cavanagh1,2,3, Perman Gochyyev4, Rashida Nayeem5
1John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, USA.
Abstract:
BackgroundVariability in movement is critical for performance under dynamic conditions. Stroke causes focal injury to the motor system, disrupts voluntary motor control, and leads to less smooth and more variable upper extremity movements. Few studies have characterized trial-by-trial variation in upper extremity movement smoothness and its clinical and neuroanatomic correlates in the first week post-stroke.ObjectiveTo evaluate trial-by-trial variation in upper extremity movement smoothness during planar reaching and relate it to clinical outcomes and neuroanatomical injury after acute stroke.MethodsTwenty-two patients (4.4 ± 1.7 days post-stroke) and 22 able-bodied adults completed a planar center-out reaching task. Smoothness was quantified with spectral arc length (SPARC). Median and interquartile range (IQR, a quantification of trial-by-trial variation) of SPARC values were assessed. Patients completed a clinical assessment battery acutely and at 90 days post-stroke. MRI-derived stroke lesions were analyzed to estimate basal ganglia, motor cortex, and corticospinal tract injury. Intraclass correlation, Spearman's correlation, and multivariate regression evaluated trial-by-trial variation and its relation to clinical assessments, outcomes, and neuroanatomical injury.ResultsPost-stroke reaching was less smooth and more variable (larger IQR) compared to able-bodied adults. Variability in post-stroke smoothness was primarily driven by within-subject, trial-by-trial variation. More variable smoothness, even after controlling for median smoothness, related to worse performance on clinical assessments and 90-day outcomes. More variable smoothness related to greater corticospinal tract injury (ρ = 0.537, P = .011), but not to basal ganglia or motor cortex injury.ConclusionTrial-by-trial variation of movement is valuable for understanding sensorimotor control post-stroke and has implications for targeted neurorehabilitation.
