Abstract
Objective
To establish the time course of recovery regarding smoothness of upper limb movements
in the first 6 months poststroke.
Design
Cohort study with 3-dimensional kinematic measurements in weeks 1, 2, 3, 4, 5, 8,
12, and 26 poststroke.
Setting
Onsite 3-dimensional kinematic measurements in stroke units, rehabilitation centers,
nursing homes, and patients' homes.
Participants
Patients (N=44; 19 women, 25 men; mean age ± SD, 58±12y) with a first-ever unilateral
ischemic stroke and incomplete upper limb paresis (27 left sided, 17 right sided)
were included.
Interventions
Not applicable.
Main Outcome Measures
In each measurement, an electromagnetic motion tracker acquired hand and finger trajectories
during a reach-to-grasp task. Movement duration was determined, and smoothness of
hand transport and grasp aperture was quantified by normalized jerk. With the use
of random coefficient analysis, the effect of progress of time on smoothness of hand
transport and grasp aperture was investigated.
Results
During the first 5 weeks poststroke, there was a significant contribution of progress
of time to reductions in movement duration and normalized jerk of hand transport and
grasp aperture (P<.01).
Conclusions
The present longitudinal 3-dimensional kinematic study showed that smoothness of paretic
upper limb movements improves in the first 8 weeks poststroke. This improvement suggests
that motor control normalizes in the first 8 weeks poststroke and can be mostly explained
by spontaneous neurologic recovery that occurs typically in the first weeks poststroke.
Future 3-dimensional kinematic studies should investigate whether therapies starting
early after stroke can improve the quality of motor control beyond spontaneous neurologic
recovery.
Keywords
List of abbreviations:
MD (movement duration), NJ (normalized jerk)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: October 24, 2013
Footnotes
This study was part of the EXPLICIT-stroke program (www.explicit-stroke.nl), which is registered with The Netherlands National Trial Register (Trial no. NTR1424). It was supported by Het Revalidatiefonds, Revalidatie Nederland, and de Nederlandse Vereniging van Revalidatieartsen (VRA) and was funded by ZonMw, The Netherlands Organization for Health Research and Development (grant no. 89000001).
No commercial party having a direct financial interest in the results of the research supporting this article has conferred or will confer a benefit on the authors or on any organization with which the authors are associated.
Identification
Copyright
© 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
