Choice of Arm Use in Stroke Survivors is Largely Driven by the Energetic Cost of the Movement.

Background: The decision of which arm to use to achieve a goal depends on energetic costs and performance abilities of each arm. Following a stroke, there is a reduction in the use of the more-impaired arm. Is it because the energetic costs of the more-impaired arm are increased, or because its use...

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Publicado en:Neurorehabilitation & Neural Repair Vol. 37; no. 4; pp. 183 - 194
Autores principales: Nguyen, Hien, Phan, Thanh, Shadmehr, Reza, Lee, Sang Wook
Formato: pictorial research tables/charts Journal Article
Publicado: Sage Publications Inc. Apr2023
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Apr2023
      vid: 37
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      pub: Sage Publications Inc.
      place: Thousand Oaks, California
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        atl: Choice of Arm Use in Stroke Survivors is Largely Driven by the Energetic Cost of the Movement.
      aug:
        au:
          Nguyen, Hien
          Phan, Thanh
          Shadmehr, Reza
          Lee, Sang Wook
        affil: Department of Biomedical Engineering, Catholic University of America, Washington, DC, USA
      sug:
        subj:
          Stroke Complications
          Stroke Rehabilitation
          Stroke Prognosis
          Stroke Patients Psychosocial Factors
          Arm Physiopathology
          Movement
          Energy Metabolism Psychosocial Factors
          Task Performance and Analysis
          Human
          Male
          Female
          Adult
          Middle Age
          Experimental Studies
          Decision Making
          Range of Motion
          Upper Extremity Physiopathology
          Virtual Reality
          Survivors Psychosocial Factors
          Funding Source
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Male
          Female
      ab: Background: The decision of which arm to use to achieve a goal depends on energetic costs and performance abilities of each arm. Following a stroke, there is a reduction in the use of the more-impaired arm. Is it because the energetic costs of the more-impaired arm are increased, or because its use dictates a lower chance of success? Objective: We sought to elucidate the impact of energetic cost and task success on the arm choice of stroke survivors. Methods: Thirteen chronic stroke survivors and thirteen neurologically-intact subjects participated in an experiment where they reached towards visual targets in a virtual-reality environment. Energetic cost of reaching with their less-used arm (nondominant/more-impaired) was adjusted by amplifying the range of motion, while task accuracy requirement was independently modulated by changing target size. Results: Reducing the energic cost of reaching increased the use of the less-used arms in both groups, but by a greater amount in the stroke survivors. In contrast, lowering task accuracy requirement altered arm choice similarly in the two groups. The time spent in decision-making (reaction time) reflected different impacts of energetic cost and task success on the arm choice of the two groups. Conversely, velocity changes were similar between the groups. Conclusions: The impact of energetic cost on arm choice of stroke survivors is greater than neurologically-intact subjects. Thus, the reduction in the use of the impaired arm following stroke may be primarily due to a subjective increase in the effort it takes to use that arm.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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