Control of paretic and non-paretic upper extremity during bimanual reaching after stroke

Abstract

Most actions of daily life engage the two upper extremities (UEs) in a highly coordinated manner. While it is recognized that bimanual movements are impaired post-stroke, understanding how the paretic and non-paretic UE contributes to this impairment is important for future interventions. We investigated kinetic and kinematics at the shoulder, elbow, and wrist joints in the paretic and non-paretic UE in 8 individuals with chronic stroke and non-dominant UE in 8 healthy controls during unimanual and bimanual tasks. Kinematic analysis revealed little effect of stroke. However, kinetic analysis revealed that during unimanual movements, joint control was impaired during unimanual and bimanual movements in both UEs, although to a lesser extent in the non-paretic than paretic UE. During bimanual movements, joint control did not change in the paretic UE, and it further deteriorated in the non-paretic UE compared with the unimanual movements. Our findings suggest that a single session of bimanual task performance does not improve joint control of the paretic UE and it impairs control of the non-paretic UE, making it more like that of the paretic UE.

Keywords:

• stroke
• hand
• bimanual
• control

Disclosure statement

The authors have no financial and/or non-financial interests that are directly or indirectly related to the work submitted for publication.

Funding

This work was supported by Department of Occupational Therapy, University of Pittsburgh.

Data availability statement

The datasets and custom MATLAB codes generated during this study comply with field standards and are available from the corresponding author (AS) upon reasonable request.

Additional information

Notes on contributors

Arjun Acharya

Amit Sethi: Participation: All of the content. Substantial contributions: Conception and design and drafting of the manuscript. Sandesh Raj: Participation: All of the content. Substantial contributions: Data collection and reviewing the manuscript. Arjun Acharya: Participation: All of the content. Substantial contributions: Data analysis and reviewing the manuscript. Natalia Dounskaia: Participation: All of the content. Substantial contributions: Overall interpretation of the results and reviewing the manuscript.

Sandesh Raj

Amit Sethi: Participation: All of the content. Substantial contributions: Conception and design and drafting of the manuscript. Sandesh Raj: Participation: All of the content. Substantial contributions: Data collection and reviewing the manuscript. Arjun Acharya: Participation: All of the content. Substantial contributions: Data analysis and reviewing the manuscript. Natalia Dounskaia: Participation: All of the content. Substantial contributions: Overall interpretation of the results and reviewing the manuscript.