Abstract
BackgroundReduction of compensation and improved movement quality indicate recovery after stroke. Since clinical measures alone are often inadequate to distinguish between behavioral recovery and compensation, kinematic analysis of functional tasks has been recommended.ObjectiveTo quantify longitudinal changes and residual deficits in movement performance and quality during the first year after stroke using kinematic analysis of drinking task.MethodsA total of 56 participants with first ever stroke causing upper extremity impairment were extracted from a non-selected stroke unit cohort (Stroke Arm Longitudinal Study at the University of Gothenburg-SALGOT). Participants needed to able to perform the drinking task with the more-affected arm at least on 2 occasions out of 6 (3 days, 10 days, 4 weeks, and 3, 6, and 12 months) during the first year to be included. A cohort of 60 healthy individuals was used as reference. Longitudinal changes were analyzed using linear mixed models.ResultsMovement time, number of movement units, peak angular velocity of the elbow, peak hand velocity, and trunk displacement improved significantly over the first 3 months with a peak at 6 months. Movement time and peak hand velocity reached levels comparable to healthy at 3 months, but number of movement units, peak elbow angular velocity, trunk displacement, and arm abduction remained different from healthy over the first year after stroke.ConclusionsEven when the recovery patterns of kinematics follow the known nonlinear pattern, not all kinematic measures reach the levels in par with healthy controls at one year post stroke. Since the number of movement units, peak angular velocity, trunk displacement, and arm abduction remained impaired over the first year, they might be the most suited measures to distinguish behavioral recovery from compensation strategies.Trial registrationClinicalTrials: NCT01115348. 4 May 2010. Retrospectively registered.
Highlights
A stroke can significantly impact a person’s ability to participate in many activities of daily living
A total of 763 patients admitted to stroke unit were screened, 117 were met the inclusion criteria of the SALGOT, and 56 of those who were able to execute the drinking task at least in two occasions during the first year post stroke were included in the current study (Fig. 1)
Stroke severity at admission measured by the National Institutes of Health Stroke Scale (NIHSS) score ranged from 0 to 24 with a median of 4 points, which indicates that most patients had moderate and mild stroke severity
Summary
A stroke can significantly impact a person’s ability to participate in many activities of daily living. Recovery of motor impairment can be characterized by the reappearance of premorbid movement patterns during task accomplishment [5]. A reduction of synergic and compensatory motor patterns resulting in improved quality of movement may be an indicator of functional restoration facilitated by neural plasticity [5, 6]. Upper-extremity activities may improve as a result of new motor patterns arising from an adaptation of the remaining motor elements or compensation by other body segments [5]. In order to capture improvements in upper extremity motor function during the first 3 months post stroke, measures of impairment are of particular interest. Reduction of compensation and improved movement quality indicate recovery after stroke. Since clinical measures alone are often inadequate to distinguish between behavioral recovery and compensation, kinematic analysis of functional tasks has been recommended
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