Abstract
Objectives
To determine (1) bimanual coordination deficits in patients with stroke using 3-dimensional
kinematic analyses as they perform naturalistic tasks requiring collaborative interaction
of the 2 arms; and (2) whether bimanual coordination deficits are related to clinical
measures of sensorimotor impairments and unimanual performance of the paretic arm.
Design
Case-control study.
Setting
Rehabilitation hospital research institute.
Participants
Participants (N=24) were patients with unilateral chronic stroke (n=14) and age-matched
controls (n=10).
Interventions
Not applicable.
Main Outcome Measures
Temporal coordination between the 2 hands as participants performed (1) a symmetric
task: reach to pick up a box using both hands; and (2) an asymmetric task: open a
drawer with 1 hand to press a button inside with the other hand.
Results
During the symmetric task, patients and controls showed preserved temporal coupling
while transporting the hands to the box. However, on reaching the box, patients demonstrated
an impaired ability to cooperatively interact their 2 arms for an efficient pickup.
This led to significantly longer pickup times compared with controls. Pickup time
positively correlated with proprioceptive deficits of the paretic arm. During the
asymmetric task, patients had a longer time delay between drawer opening and button
pressing movements than controls. The deficits in asymmetric coordination did not
significantly correlate with sensorimotor impairments or unimanual paretic arm performance.
Conclusions
Bimanual coordination was impaired in patients poststroke during symmetric and asymmetric
bimanual tasks that required cooperative interaction between the 2 arms. While the
proprioceptive system contributes to symmetric cooperative coordination, commonly
tested measures of paretic arm impairment or performance, or both, do not strongly
predict deficits in bimanual coordination.
Keywords
List of abbreviations:
GS (goal synchronization), MT (movement time), OS (onset synchronization), PTP (pull to press), RTP (reach to pickup), TC (transport coordination), UEFM (upper extremity Fugl-Meyer)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: February 10, 2016
Footnotes
Supported by the Moss Rehabilitation Research Institute.
Disclosures: none.
Identification
Copyright
© 2016 The American Congress of Rehabilitation Medicine.
