Abstract
Background: Visuomotor performance can be improved by repetitive training on consecutive days. The aim of this study was to assess the training effect of visuomotor tracking in healthy subjects and hemiparetic patients with stroke and in moderately impaired patients with Parkinson’s disease. Methods: 39 healthy right-handed subjects, 15 patients after acute cerebral artery stroke, and 15 patients with mid-stage Parkinson’s disease were trained with the commercially available, multifunctional PABLOR-device. This handhold device is equipped with force and acceleration sensors and connected to a personal computer for on-line data display and data storage. On three consecutive days the subjects were trained to navigate a target through obstacles in a virtual reality environment. Performance was assessed by modulation of force production and rotation of the hand in a visuomotor tracking paradigm using the PABLOR-device. Results: The main findings were that training of the right dominant hand improved visuomotor coordination of hand rotation movements in both hands in the healthy subjects (p=0.0015). Training of the right affected hand improved visuomotor coordination of hand rotation movements in either patient group (p=0.026). In contrast, training improved the visuomotor coordination of force tracking of the dominant hand only in the healthy subjects (p<0.01). Conclusions: The visuomotor training scenario was effective to improve visually guided hand coordination within three days in the healthy controls and both patient groups. The improvement of hand rotation generalized to the nontrained hand in healthy subjects.
Highlights
Visuomotor performance can be improved by repetitive training on consecutive days
15 consecutive patients aged 61 ± 12 (SD) years who were treated at our stroke unit because of an acute mild hemiparetic brain infarction mainly affecting the hand motor function (5 ± 3 days after stroke) were included as one patient group (Table 1)
ANOVA testing revealed that there was no change of the mean hand grip force and the mean pinch grip force as well as of the mean angle of hand rotation between the test sessions in either group (F-value 0.01; p=0.975, DF 38 for healthy volunteers, DF 14 for either patient group)
Summary
Visuomotor performance can be improved by repetitive training on consecutive days. The aim of this study was to assess the training effect of visuomotor tracking in healthy subjects and hemiparetic patients with stroke and in moderately impaired patients with Parkinson’s disease. Most important are elevations of the hand and arm as produced by movements at the shoulder joint, grip force exertion with the hand, pinch grip of index finger and thumb, fractionated finger movements for object exploration, as well as rotating movements of the hand resulting in a supination or pronation of the wrist. These movements can be affected differentially by diseases of the central and peripheral nervous system. For longitudinal studies in the clinical field as well as in neurorehabilitation, quantitative measures of arm and hand movements are mandatory to monitor the effect of therapeutic interventions
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