TY - JOUR
T1 - Impact of Time on Quality of Motor Control of the Paretic Upper Limb After Stroke
AU - van Kordelaar, J.
AU - van Wegen, E.E.H.
AU - Kwakkel, G.
PY - 2014
Y1 - 2014
N2 - 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. © 2014 by the American Congress of Rehabilitation Medicine.
AB - 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. © 2014 by the American Congress of Rehabilitation Medicine.
U2 - https://doi.org/10.1016/j.apmr.2013.10.006
DO - https://doi.org/10.1016/j.apmr.2013.10.006
M3 - Article
C2 - 24161273
SN - 0003-9993
VL - 95
SP - 338
EP - 344
JO - Archives of physical medicine and rehabilitation
JF - Archives of physical medicine and rehabilitation
IS - 2
ER -