Joost van Kordelaar1, Erwin van Wegen1, Gert Kwakkel2. 1. Department of Rehabilitation Medicine, MOVE Research Institute Amsterdam, VU University Medical Center, Amsterdam, The Netherlands. 2. Department of Rehabilitation Medicine, MOVE Research Institute Amsterdam, VU University Medical Center, Amsterdam, The Netherlands; Amsterdam Rehabilitation Research Center, Reade Centre for Rehabilitation and Rheumatology, Amsterdam, The Netherlands. Electronic address: g.kwakkel@vumc.nl.
Abstract
OBJECTIVE: To establish the time course of recovery regarding smoothness of upper limb movements in the first 6 months poststroke. DESIGN: Cohort study with 3-dimensional kinematic measurements in weeks 1, 2, 3, 4, 5, 8, 12, and 26 poststroke. SETTING: Onsite 3-dimensional kinematic measurements in stroke units, rehabilitation centers, nursing homes, and patients' homes. PARTICIPANTS: Patients (N=44; 19 women, 25 men; mean age ± SD, 58±12y) with a first-ever unilateral ischemic stroke and incomplete upper limb paresis (27 left sided, 17 right sided) were included. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: In each measurement, an electromagnetic motion tracker acquired hand and finger trajectories during a reach-to-grasp task. Movement duration was determined, and smoothness of hand transport and grasp aperture was quantified by normalized jerk. With the use of random coefficient analysis, the effect of progress of time on smoothness of hand transport and grasp aperture was investigated. RESULTS: During the first 5 weeks poststroke, there was a significant contribution of progress of time to reductions in movement duration and normalized jerk of hand transport and grasp aperture (P<.01). CONCLUSIONS: The present longitudinal 3-dimensional kinematic study showed that smoothness of paretic upper limb movements improves in the first 8 weeks poststroke. This improvement suggests that motor control normalizes in the first 8 weeks poststroke and can be mostly explained by spontaneous neurologic recovery that occurs typically in the first weeks poststroke. Future 3-dimensional kinematic studies should investigate whether therapies starting early after stroke can improve the quality of motor control beyond spontaneous neurologic recovery.
OBJECTIVE: To establish the time course of recovery regarding smoothness of upper limb movements in the first 6 months poststroke. DESIGN: Cohort study with 3-dimensional kinematic measurements in weeks 1, 2, 3, 4, 5, 8, 12, and 26 poststroke. SETTING: Onsite 3-dimensional kinematic measurements in stroke units, rehabilitation centers, nursing homes, and patients' homes. PARTICIPANTS: Patients (N=44; 19 women, 25 men; mean age ± SD, 58±12y) with a first-ever unilateral ischemic stroke and incomplete upper limb paresis (27 left sided, 17 right sided) were included. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: In each measurement, an electromagnetic motion tracker acquired hand and finger trajectories during a reach-to-grasp task. Movement duration was determined, and smoothness of hand transport and grasp aperture was quantified by normalized jerk. With the use of random coefficient analysis, the effect of progress of time on smoothness of hand transport and grasp aperture was investigated. RESULTS: During the first 5 weeks poststroke, there was a significant contribution of progress of time to reductions in movement duration and normalized jerk of hand transport and grasp aperture (P<.01). CONCLUSIONS: The present longitudinal 3-dimensional kinematic study showed that smoothness of paretic upper limb movements improves in the first 8 weeks poststroke. This improvement suggests that motor control normalizes in the first 8 weeks poststroke and can be mostly explained by spontaneous neurologic recovery that occurs typically in the first weeks poststroke. Future 3-dimensional kinematic studies should investigate whether therapies starting early after stroke can improve the quality of motor control beyond spontaneous neurologic recovery.
Authors: Margit Alt Murphy; Steve Murphy; Hanna C Persson; Ulla-Britt Bergström; Katharina Stibrant Sunnerhagen Journal: J Vis Exp Date: 2018-03-28 Impact factor: 1.355
Authors: Juan C Cortes; Jeff Goldsmith; Michelle D Harran; Jing Xu; Nathan Kim; Heidi M Schambra; Andreas R Luft; Pablo Celnik; John W Krakauer; Tomoko Kitago Journal: Neurorehabil Neural Repair Date: 2017-03-16 Impact factor: 3.919
Authors: Brenton Hordacre; Duncan Austin; Katlyn E Brown; Lynton Graetz; Isabel Pareés; Stefania De Trane; Ann-Maree Vallence; Simon Koblar; Timothy Kleinig; Michelle N McDonnell; Richard Greenwood; Michael C Ridding; John C Rothwell Journal: Neurorehabil Neural Repair Date: 2021-02-12 Impact factor: 3.919
Authors: Susan V Duff; Jiaxiu He; Monica A Nelsen; Christianne J Lane; Veronica T Rowe; Steve L Wolf; Alexander W Dromerick; Carolee J Winstein Journal: Neurorehabil Neural Repair Date: 2014-10-16 Impact factor: 3.919
Authors: Charalambos C Charalambous; Erin E Helm; Kristin A Lau; Susanne M Morton; Darcy S Reisman Journal: Top Stroke Rehabil Date: 2017-11-05 Impact factor: 2.119
Authors: Judith Dm Vloothuis; Marijn Mulder; Janne M Veerbeek; Manin Konijnenbelt; Johanna Ma Visser-Meily; Johannes Cf Ket; Gert Kwakkel; Erwin Eh van Wegen Journal: Cochrane Database Syst Rev Date: 2016-12-21