Influence of reactive and proactive motor decision strategies on hand kinematic characteristics in stroke patients

Abstract

Motor dysfunction of the upper limbs is often a consequence of a stroke. The use of traditional methods to restore upper limb motor function has limited efficacy, and the search for and development of new rehabilitation approaches is a pressing issue. In the present study, two groups of patients with upper limb dysfunction after stroke performed goal-directed arm movement training. The training consisted of 10 sessions of 10 minutes each. Patients chose one of two targets, either a close, frontal target or a more distant target to the side of the extensor arm. The groups differed in the presentation of the distant target, which was more difficult to move, whereas the near target, which was easier to move, was stationary. The results suggest that, in contrast to the effects common to both groups of reduced movement onset time, greater movement velocity in reaching the distant target, reduced rate and mean distance of the selected distant target, differences in the presentation of the distant target between the groups have an impact on the dynamics of arm movement training in patients. Presenting a target at a random distance results in a greater selection distance, a less pronounced decrease in movement onset time and an increase in hand velocity compared to the adaptive presentation algorithm. The results of the study may be useful in selecting a rehabilitation strategy for stroke patients.