Task-dependent bimanual coordination after stroke: Relationship with sensorimotor impairments

Publication date: Available online 10 February 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Shailesh S. Kantak, Nazaneen Zahedi, Robert L. McGRath
ObjectivesTo determine bimanual coordination deficits in patients with stroke using 3-D kinematic analyses as they perform naturalistic tasks requiring collaborative interaction of the two arms. To determine if bimanual coordination deficits are related to clinical measures of sensorimotor impairments and unimanual performance of the paretic arm.DesignCase-control studySettingRehabilitation hospital research InstituteParticipants14 patients with unilateral chronic stroke and 10 age-matched control participantsInterventionsNot applicableMain Outcome measuresTemporal coordination between the two hands as participants performed (1) symmetric task: reach-to-pick up a box using both hands and (2) asymmetric task: open a drawer with one hand to press a button inside with the other hand.ResultsDuring the symmetric task, patients and controls showed preserved temporal coupling while transporting the hands to the box. However, upon reaching the box, patients demonstrated impaired ability to cooperatively interact their two arms for an efficient pick-up. This led to significantly longer pickup times compared to controls. Pickup time positively correlated with proprioceptive deficits of the paretic arm. During the asymmetric task, patients had longer time-delay between drawer opening and button pressing movements than controls. The deficits in asymmetric coordination did not significantly correlate with sensory-motor impairments or unimanual paretic arm performance.ConclusionsBimanual coordination was impaired in patients post-stroke during symmetric and asymmetric bimanual tasks that required cooperative interaction between the two arms. While proprioceptive system contributes to symmetric cooperative coordination, commonly-tested measures of paretic arm impairment and/or performance do not strongly predict deficits in bimanual coordination.



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