Accepted for/Published in: JMIR Rehabilitation and Assistive Technologies
Date Submitted: Jul 5, 2023
Date Accepted: Sep 21, 2023
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Movement Component Analysis of Reaching Strategy in Individuals with Stroke: A preliminary study
ABSTRACT
Background:
Upper limb motor paresis is a major symptom of patients with stroke, limits activities of daily living, and compromises quality of life. This study aimed to compare the movement strategies of individuals with hemiparesis due to stroke and healthy individuals in forward and hand-to-mouth reach, using a methodology designed to quantify the contribution of various movement components to the reaching action.
Objective:
To introduce a method for three-dimensional motion analysis that proffers information instrumental to clinical decision-making, by measuring both goal attainment, here denoted as reaching a target, and dependence on compensatory movements.
Methods:
A three-dimensional motion analysis with a simplified marker set (placed at the seventh cervical vertebra, acromion, lateral epicondyle of the humerus, MP joint of the index finger, and greater trochanter) was conducted. For the forward reach, the forward distance traveled by the finger MP joint from the starting position to the forward target location on the anterior–posterior axis was measured. For the hand-to-mouth reach, the shortening of the vertical distance between the index finger MP joint and the position of the chin at the start of the measurement was measured. For both measurements, the contributions of relevant upper limb and trunk movements were calculated.
Results:
Twenty healthy individuals and ten stroke patients participated in this study. In the forward reach, the contribution of shoulder/elbow flexion was significantly smaller in participants with stroke than in healthy participants (52.5%±24.5% vs. 85.2%±4.5%, p < 0.001), whereas the contribution of trunk flexion was significantly larger in stroke participants than in healthy participants (34.0%±28.5% vs. 3.0%±2.8%, p < 0.001). In the hand-to-mouth reach, the contribution of shoulder/elbow flexion was significantly smaller in participants with stroke than in healthy participants (71.8%±23.7% vs. 90.7%±11.8%, p = 0.009), whereas shoulder girdle elevation and shoulder abduction were significantly larger in participants with stroke than in healthy participants (10.5%±5.7% vs. 6.5%±3.0%, p = 0.024 and 16.5%±18.7% vs. 3.0%±10.4%, p = 0.021, respectively).
Conclusions:
Compared with healthy participants, participants with stroke gained a significantly greater distance via trunk flexion in the forward reach and shoulder abduction and shoulder girdle elevation in the hand-to-mouth reach which are regarded as compensatory movements. Understanding the characteristics of individual motor strategies, such as dependence on compensatory movements, may contribute to tailored goal setting in stroke rehabilitation. Clinical Trial: N/A
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