Performance of discrete, reciprocal, and cyclic movements of the ipsilesional upper limb in individuals after stroke.

Abstract

Aiming movements of the upper limbs can be classified either as discrete, or reciprocal, or cyclic. The control of these movements after a stroke can be affected. The aim of this experimental, cross-sectional study was to characterize the performance of these movements after the right and left hemisphere chronic stroke. Thirty-six individuals aged between 40 and 70years, right-handed, were allocated into three groups (control, right stroke, and left stroke). Participants were asked to perform aiming movements on a tablet. Individuals after stroke performed the tasks only with their ipsilesional limb, while the control group performed movements with both limbs. The reaction and movement times, peak velocity, and the variability and error of the endpoint were analyzed. Individuals after stroke presented a worse performance in all movement classes as expected, but differently depending on the damaged hemisphere. Participants with right hemisphere damage showed larger endpoint errors, while those with left hemisphere damage had longer reaction and movement times. Both differences were seen consistently in discrete and reciprocal, but not in cyclic movements. Cyclic movements presented shorter latencies, were faster, and showed greater endpoint errors when compared to discrete and reciprocal movements. These results suggest that stroke affects differently the performance of discrete and reciprocal movements according to the hemisphere lesion side, but not in cyclic movements. Different levels of motor control among the three classes of movements by the nervous system may justify these results.