Abstract
BackgroundFollowing stroke, patients frequently demonstrate loss of motor control and function and altered kinematic parameters of reaching movements. Feedback is an essential component of rehabilitation and auditory feedback of kinematic parameters may be a useful tool for rehabilitation of reaching movements at the impairment level. The aim of this study was to investigate the effect of 2 types of auditory feedback on the kinematics of reaching movements in hemiparetic stroke patients and to compare differences between patients with right (RHD) and left hemisphere damage (LHD).Methods10 healthy controls, 8 stroke patients with LHD and 8 with RHD were included. Patient groups had similar levels of upper limb function. Two types of auditory feedback (spatial and simple) were developed and provided online during reaching movements to 9 targets in the workspace. Kinematics of the upper limb were recorded with an electromagnetic system. Kinematics were compared between groups (Mann Whitney test) and the effect of auditory feedback on kinematics was tested within each patient group (Friedman test).ResultsIn the patient groups, peak hand velocity was lower, the number of velocity peaks was higher and movements were more curved than in the healthy group. Despite having a similar clinical level, kinematics differed between LHD and RHD groups. Peak velocity was similar but LHD patients had fewer velocity peaks and less curved movements than RHD patients. The addition of auditory feedback improved the curvature index in patients with RHD and deteriorated peak velocity, the number of velocity peaks and curvature index in LHD patients. No difference between types of feedback was found in either patient group.ConclusionIn stroke patients, side of lesion should be considered when examining arm reaching kinematics. Further studies are necessary to evaluate differences in responses to auditory feedback between patients with lesions in opposite cerebral hemispheres.
Highlights
Following stroke, patients frequently demonstrate loss of motor control and function and altered kinematic parameters of reaching movements
Peak hand velocity was scaled according to target distance in healthy subjects as well as in patients with right hemisphere damage (RHD) and left hemisphere damage (LHD), to a lesser extent in the patient groups
Kinematic performance of healthy subjects was significantly better than patients and performance of LHD patients was significantly better than RHD patients
Summary
Patients frequently demonstrate loss of motor control and function and altered kinematic parameters of reaching movements. Studies using movement analysis techniques have shown alterations in movement patterns following stroke, including: decreased velocity, alterations in the shape of the velocity curve, loss of smoothness and loss of inter-joint coordination [2,3]. These impairments may result as a direct consequence of the lesion secondary compensatory strategies are observed [2]. Rehabilitation aims to improve function but training at the impairment level may be necessary so that patients reach their full potential [4]. The addition of augmented feedback may help to improve movement performance and complement conventional therapy
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