Kinematic upper extremity performance in people with near or fully recovered sensorimotor function after stroke

ABSTRACT

Background: Clinical scales for upper extremity motor function may not capture improvement among higher functioning people with stroke. Objective: To describe upper extremity kinematics in people with stroke who score within the upper 10% of the Fugl-Meyer Assessment (FMA-UE) and explore the ceiling effects of the FMA-UE. Design: A cross-sectional study design was used. Participants: People with stroke were included from the Stroke Arm Longitudinal Study at University of Gothenburg together with 30 healthy controls. The first analysis included participants who achieved FMA-UE score > 60 within the first year of stroke (assessed at 3 days, 2 weeks, 4 weeks, 3 months, or 12 months post stroke). The second analysis included participants with submaximal FMA-UE (60–65 points, n = 24) or maximal FMA-UE score (66 points, n = 21) at 3 months post stroke. Measurements: The kinematic analysis of a standardized drinking task included movement time, velocity and strategy, joint angles of the elbow, and shoulder and trunk displacement. Results: The high FMA-UE stroke group showed deficits in seven of eight kinematic variables. The submaximal FMA-UE stroke group was slower, had lower tangential and angular peak velocity, and used more trunk displacement than the controls. In addition, the maximal FMA-UE stroke group showed larger trunk displacement and arm abduction during drinking and lower peak angular velocity of the elbow. Conclusions: Participants with near or fully recovered sensorimotor function after stroke still show deficits in movement kinematics; however, the FMA-UE may not be able to detect these impairments.

KEYWORDS:

• Stroke
• upper extremity
• movement analysis
• kinematics
• task performance and analysis
• activities of daily living

Acknowledgment

We thank Eva-Lena Bustrén for helping with data collection and Risk-Stroke Collaboration for helping with the demographic data. This study was funded in parts by the Swedish Research Council (VR 2012-70X-22122-01-3), Swedish Heart and Lung Foundation, Swedish Brain Foundation, Norrbacka Eugenia Foundation, Foundation of the Swedish National Stroke Association, Local Research and Development Board for Gothenburg and Södra Bohuslän, Promobila, and Hjalmar Svensson Research Foundation.

Declarations of interest

The authors declare no conflict of interest.

Additional information

Funding

This study was funded in parts by the Swedish Research Council [VR 2012-70X-22122-01-3], Swedish Heart and Lung Foundation, Swedish Brain Foundation, Norrbacka Eugenia Foundation, Foundation of the Swedish National Stroke Association, Local Research and Development Board for Gothenburg and Södra Bohuslän, Promobila, Hjalmar Svensson Research Foundation.