Altered Anticipatory Postural Adjustments During Whole-Body Reaching in Subjects With Stroke.

Background: Coordination between arm movements and postural adjustments is crucial for reaching-while-stepping tasks involving both anticipatory postural adjustments (APAs) and compensatory movements to effectively propel the whole-body forward so that the hand can reach the target. Stroke impairs t...

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Published in:Neurorehabilitation & Neural Repair Vol. 38; no. 3; pp. 176 - 187
Main Authors: Tomita, Yosuke, Mullick, Aditi A., Feldman, Anatol G., Levin, Mindy F.
Format: equations & formulas research tables/charts Journal Article
Published: Sage Publications Inc. Mar2024
Online Access:View this record in EBSCOhost
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      dt: Mar2024
      vid: 38
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      pub: Sage Publications Inc.
      place: Thousand Oaks, California
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        atl: Altered Anticipatory Postural Adjustments During Whole-Body Reaching in Subjects With Stroke.
      aug:
        au:
          Tomita, Yosuke
          Mullick, Aditi A.
          Feldman, Anatol G.
          Levin, Mindy F.
        affil: Department of Physical Therapy, Faculty of Health Care, Takasaki University of Health and Welfare, Gunma, Japan
      sug:
        subj:
          Stroke Complications
          Balance, Postural
          Reaching
          Task Performance and Analysis
          Funding Source
          Human
          Descriptive Statistics
          Data Analysis Software
          Chronic Disease
          Kinematics
          Male
          Female
          Middle Age
          Aged
          Aged, 80 and Over
          Scales
          Clinical Assessment Tools
          Mann-Whitney U Test
          Wilcoxon Signed Rank Test
          Confidence Intervals
          Odds Ratio
          Middle Aged: 45-64 years
          Aged: 65+ years
          Aged, 80 & over
          Male
          Female
      ab: Background: Coordination between arm movements and postural adjustments is crucial for reaching-while-stepping tasks involving both anticipatory postural adjustments (APAs) and compensatory movements to effectively propel the whole-body forward so that the hand can reach the target. Stroke impairs the ability to coordinate the action of multiple body segments but the underlying mechanisms are unclear. Objective. To determine the effects of stroke on reaching performance and APAs during whole-body reaching. Methods: We tested arm reaching in standing (stand-reach) and reaching-while-stepping (step-reach; 15 trials/condition) in individuals with chronic stroke (n = 18) and age-matched healthy subjects (n = 13). Whole-body kinematics and kinetic data were collected during the tasks. The primary outcome measure for step-reach was "gain" (g), defined as the extent to which the hip displacement contributing to hand motion was neutralized by appropriate changes in upper limb movements (g = 1 indicates complete compensation) and APAs measured as spatio-temporal profiles of the center-of-pressure shifts preceding stepping. Results: Individuals with stroke had lower gains and altered APAs compared to healthy controls. In addition, step onset was delayed, and the timing of endpoint, trunk, and foot movement offset was prolonged during step-reach compared to healthy controls. Those with milder sensorimotor impairment and better balance function had higher gains. Altered APAs were also related to reduced balance function. Conclusions: Altered APAs and prolonged movement offset in stroke may lead to a greater reliance on compensatory arm movements. Altered APAs in individuals with stroke may be associated with a reduced shift of referent body configuration during the movement
      pubtype: Academic Journal
      doctype:
        equations & formulas
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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