Chronic Stroke Survivors Improve Reaching Accuracy by Reducing Movement Variability at the Trained Movement Speed

Neurorehabilitation and Neural Repair
Ulrike HammerbeckJohn C Rothwell

Abstract

Recovery from stroke is often said to have "plateaued" after 6 to 12 months. Yet training can still improve performance even in the chronic phase. Here we investigate the biomechanics of accuracy improvements during a reaching task and test whether they are affected by the speed at which movements are practiced. We trained 36 chronic stroke survivors (57.5 years, SD ± 11.5; 10 females) over 4 consecutive days to improve endpoint accuracy in an arm-reaching task (420 repetitions/day). Half of the group trained using fast movements and the other half slow movements. The trunk was constrained allowing only shoulder and elbow movement for task performance. Before training, movements were variable, tended to undershoot the target, and terminated in contralateral workspace (flexion bias). Both groups improved movement accuracy by reducing trial-to-trial variability; however, change in endpoint bias (systematic error) was not significant. Improvements were greatest at the trained movement speed and generalized to other speeds in the fast training group. Small but significant improvements were observed in clinical measures in the fast training group. The reduction in trial-to-trial variability without an alteration to endpoint bias sug...Continue Reading

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Citations

Jul 23, 2020·Frontiers in Neurology·Echezona Nelson Dominic EkechukwuMayowa Ojo Owolabi
May 17, 2021·Journal of Bodywork and Movement Therapies·Tamise Aguiar CairesGustavo José Luvizutto
Aug 11, 2021·Disability and Rehabilitation·Ulrike HammerbeckSarah Tyson

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