(Stroke. 2001;32:1875.)
© 2001 American Heart Association, Inc.
Original Contributions |
Effect of Trunk Restraint on the Recovery of Reaching Movements in Hemiparetic Patients
From the School of Rehabilitation, University of Montreal and Research Centre, Rehabilitation Institute of Montréal, Quebec, Canada (S.M.M., A.L., M.F.L.); and CNRS EP 1848 and Hôpital Raymond-Poincaré, Garches, France (A.R.-B.).
Correspondence to Mindy F. Levin, PhD, Research Centre of Rehabilitation Institute of Montreal, CRIR, 6300 Darlington, Montreal, Quebec H3S 2J4, Canada. E-mail levinm{at}poste.umontreal.ca
Background and Purpose—— Reaching movements made with the affected arm in hemiparetic patients are often accompanied by compensatory trunk or shoulder girdle movements, which extend the reach of the arm. We investigated the effects of the suppression of these compensatory movements on reaching ability in hemiparetic individuals.
Methods—— Eleven healthy and 11 hemiparetic individuals participated. Three-dimensional kinematic analysis was used to quantify reaches made to a close and a distant target (near the limit of arm’s length). Unrestrained reaches were compared with those in which shoulder girdle and trunk movements were restrained by a harness.
Results—— During unrestrained reaching, abnormal trunk recruitment and limitations in elbow and shoulder movements were correlated with the degree of clinical stroke severity (r=-0.91 to -0.96) in hemiparetic patients. During trunk restraint, ranges of elbow and shoulder joint movement increased in both groups. In addition, elbow and shoulder interjoint coordination improved. This was caused by increases in the range of joint motion as well as by a better dynamic temporal relation between joints.
Conclusions—— Trunk restraint allowed patients with hemiparetic stroke to make use of arm joint ranges that are present but not normally recruited during unrestrained arm-reaching tasks. Thus, the underlying "normal" patterns of movement coordination may not be entirely lost after stroke. Appropriate treatments, such as trunk restraint, may be effective in uncovering latent movement patterns to maximize arm recovery in hemiparetic patients.
Key Words: arm • hemiplegia • motor control • recovery • therapy
This article has been cited by other articles:
 |
|
 |
|
  M. L. Woodbury, D. R. Howland, T. E. McGuirk, S. B. Davis, C. R. Senesac, S. Kautz, and L. G. Richards Effects of Trunk Restraint Combined With Intensive Task Practice on Poststroke Upper Extremity Reach and Function: A Pilot Study Neurorehabil Neural Repair, January 1, 2009; 23(1): 78 - 91. [Abstract] [PDF]
|
|
|
|
|
|
M. D. Ellis, T. Sukal, T. DeMott, and J. P. A. Dewald Augmenting Clinical Evaluation of Hemiparetic Arm Movement With a Laboratory-Based Quantitative Measurement of Kinematics as a Function of Limb Loading Neurorehabil Neural Repair, July 1, 2008; 22(4): 321 - 329. [Abstract] [PDF]
|
|
|
|
 |
|
 D. S Reisman and J. P Scholz Deficits in Surface Force Production During Seated Reaching in People After Stroke Physical Therapy, March 1, 2007; 87(3): 326 - 336. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. M. Michaelsen, R. Dannenbaum, and M. F. Levin Task-Specific Training With Trunk Restraint on Arm Recovery in Stroke: Randomized Control Trial Stroke, January 1, 2006; 37(1): 186 - 192. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. M. Michaelsen and M. F. Levin Short-Term Effects of Practice With Trunk Restraint on Reaching Movements in Patients With Chronic Stroke: A Controlled Trial Stroke, August 1, 2004; 35(8): 1914 - 1919. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. S. Reisman and J. P. Scholz Aspects of joint coordination are preserved during pointing in persons with post-stroke hemiparesis Brain, November 1, 2003; 126(11): 2510 - 2527. [Abstract] [Full Text] [PDF]
|
|