Neuroplasticity and Motor Behavior Laboratory, Moss Rehabilitation Research Institute, Elkins Park, PA, 19027, USA.
Department of Health and Rehabilitation Sciences, Temple University, Philadelphia, PA, USA.
Exp Brain Res. 2022 Sep;240(9):2359-2373. doi: 10.1007/s00221-022-06419-2. Epub 2022 Jul 23.
The perceptual feature of a task such as how a task goal is perceived influences performance and coordination of bimanual actions in neurotypical adults. To assess how bimanual task goal modifies paretic and non-paretic arm performance and bimanual coordination in individuals with stroke affecting left and right hemispheres, 30 participants with hemispheric stroke (15 right-hemisphere damage-RHD); 15 left-hemisphere damage-LHD) and 10 age-matched controls performed reach-to-grasp and pick-up actions under bimanual common-goal (i.e., two physically coupled dowels), bimanual independent-goal (two physically uncoupled dowels), and unimanual conditions. Reach-to-grasp time and peak grasp aperture indexed motor performance, while time lags between peak reach velocities, peak grasp apertures, and peak pick-up velocities of the two hands characterized reach, grasp, and pick-up coordination, respectively. Compared to unimanual actions, bimanual actions significantly slowed non-paretic arm speed to match paretic arm speed, thus affording no benefit to paretic arm performance. Detriments in non-paretic arm performance during bimanual actions was more pronounced in the RHD group. Under common-goal conditions, movements were faster with smaller peak grasp apertures compared to independent-goal conditions for all groups. Compared to controls, individuals with stroke demonstrated poor grasp and pick-up coordination. Of the patient groups, patients with LHD showed more pronounced deficits in grasp coordination between hands. Finally, grasp coordination deficits related to paretic arm motor deficits (upper extremity Fugl-Meyer score) for LHD group, and to Trail-Making Test performance for RHD group. Findings suggest that task goal and distinct clinical deficits influence bimanual performance and coordination in patients with left- and right-hemispheric stroke.
任务的感知特征，如任务目标的感知方式，会影响神经正常成年人的双手动作表现和协调性。为了评估双侧任务目标如何改变偏瘫上肢和非偏瘫上肢的表现以及影响左右半球的脑卒中患者的双手协调性，30 名脑卒中患者（15 名右侧半球损伤-RHD；15 名左侧半球损伤-LHD）和 10 名年龄匹配的对照组在双手共同目标（即两个物理上耦合的销钉）、双手独立目标（两个物理上未耦合的销钉）和单手条件下执行伸手抓握和拿起动作。伸手抓握时间和最大抓握孔径指标运动表现，而双手的最大伸手速度、最大抓握孔径和最大拿起速度之间的时间滞后分别描述了伸手、抓握和拿起的协调性。与单手动作相比，双手动作显著降低了非偏瘫上肢的速度以匹配偏瘫上肢的速度，因此对偏瘫上肢的表现没有益处。在双手动作中，非偏瘫上肢的表现受损在 RHD 组更为明显。在共同目标条件下，与独立目标条件相比，所有组的运动速度都更快，最大抓握孔径更小。与对照组相比，脑卒中患者的抓握和拿起协调性较差。在患者组中，LHD 患者双手之间的抓握协调性明显较差。最后，LHD 组的抓握协调性缺陷与偏瘫上肢运动缺陷（上肢 Fugl-Meyer 评分）相关，而 RHD 组与 Trail-Making 测试表现相关。研究结果表明，任务目标和不同的临床缺陷会影响左、右半球脑卒中患者的双手表现和协调性。
