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From the Department of Neurology, Massachusetts General Hospital (G.N.,
S.C.C., J.D.K., S.P.F.); Spaulding Rehabilitation Hospital, Harvard Medical
School (G.N., J.D.K., S.P.F.); Northeastern University, Bouvé College
of Pharmacy and Health Sciences (J.D.S.); NeuroRecovery Program, Massachusetts
General Hospital–Spaulding (G.N., S.C.C., J.D.S., J.D.K., S.P.F.),
Boston, Mass; and the Clinical Investigator Training Program, Harvard-MIT
Division of Health Sciences and Technology and Beth Israel–Deaconess
Medical Center, Boston, Mass, in collaboration with Pfizer Inc (S.C.C).
Correspondence to Gereon Nelles, MD, Neurologisches Therapiezentrum, Philippusstift und Neurologische Universitätsklinik, Laarmannstr 14, D-45359 Essen, Germany. E-mail gereon.nelles{at}uni-essen.de
Abstract
Background and Purpose—Mirror
movements (MM) are involuntary synchronous movements of one limb during
voluntary unilateral movements of the opposite limb. We measured MM in
stroke and control subjects and evaluated whether MM after stroke are
related to motor function.
Methods—Twenty-three patients and 16 control subjects were
studied. A computerized dynamometer was used during two squeezing tasks
to measure intended movements from the active hand as well as MM from
the opposite hand. Motor deficits were measured with the arm motor
component of the Fugl-Meyer scale.
Results—During paretic hand squeezing, MM in the unaffected hand
were detected in 70% (repetitive squeeze) to 78% (sustained squeeze)
of stroke patients. For both tasks, this was significantly
(P<0.05) greater than the incidence of MM in the
paretic hand or in either hand of control subjects (17% to 44%),
except when compared with the incidence of MM in the dominant hand of
control subjects (56%; P=0.17). The incidence of MM in
the paretic hand was not significantly different from that seen in
either hand of control subjects. Patients with MM in the unaffected
hand had significantly greater motor deficit than patients without MM.
Patients with MM in the paretic hand had significantly better motor
function than patients without MM.
Conclusions—Simultaneously recording motor
performances of both hands provides precise information to
characterize MM. MM in the unaffected hand and in the paretic hand are
associated with different degrees of motor deficit after stroke.
Evaluation of MM may be useful for studying mechanisms of stroke
recovery.
© 1998 American Heart Association, Inc.
Original Contribution
Quantitative Assessment of Mirror Movements After Stroke
Key Words: dynamometer, computerized • mirror movements • motor activity • stroke, outcome
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