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(Stroke. 2001;32:70.)
© 2001 American Heart Association, Inc.

Original Contributions

Effects of Task Goal and Personal Preference on Seated Reaching Kinematics After Stroke

Ching-yi Wu, ScD, OTR; May-kuen Wong, MD; Keh-chung Lin, ScD, OTR Hsieh-ching Chen, PhD

From the Department of Occupational Therapy, Chang Gung University (C.W.), and the Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital (M.W.), Taoyuan; the School of Occupational Therapy, College of Medicine, National Taiwan University and Department of Rehabilitation, National Taiwan University Hospital, Taipei (K.L.); and the Department of Industrial Engineering and Management, Chaoyang University of Technology, Wufong (H.C.), Taiwan.

Correspondence to Dr Keh-chung Lin, School of Occupational Therapy, College of Medicine, National Taiwan University, 7 Chung Shan South Rd, Taipei 100, Taiwan. E-mail kclin{at}ha.mc.ntu.edu.tw

Background and Purpose—Current theories of motor control in rehabilitation focus on how the nervous system responds to many types of external and internal constraints to execute motor behavior to accomplish a task. However, the dynamic interplay between these 2 constraints remains unclear. This study examined the impact of some aspects of internal and external constraints on motor performance in persons with stroke.

Methods—Twenty-seven persons with stroke used the uninvolved arms to perform an upper-extremity reaching task under 4 experimental conditions, formed by the crossing of functional goals and personal preferences. For the higher level of a functional goal, subjects took a drink from a can of beverage. For the lower level of a functional goal, subjects brought the can to the mouth without drinking. The level of personal preferences was determined, by interview, by the degree of predilection for particular beverages.

Results—Significant and large effects of functional goals and personal preference were found in the variables of movement time and reaction time. However, the data trend of the 4 testing conditions varied according to presence of visuospatial neglect and side of lesion.

Conclusions—Offering choices for the treatment activities and incorporating functional goals to therapeutic tasks might enhance response rate or movement efficiency, depending on the side of the lesion and presence of visuospatial neglect. The findings suggest that the consideration of the neglect phenomenon is a necessity when rehabilitative treatment planning incorporates constraint factors.

Key Words: hemiplegia • motor activity • neglect • rehabilitation

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