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"Background: Bimanual coordination is a major component of normal movement. Coordination impairments are common following stroke and may lead to limitations in performance of activities of daily living, participation and quality of life. Coordination deficits are under evaluated in patients with stroke due to the lack of validated assessments. Therefore, the clinical relationship between bimanual coordination deficits and limitations in functional recovery is unclear. Objective: The Interlimb Coordination test (ILC2) is one element of a comprehensive outcome measure (Comprehensive Coordination Scale) developed by our group, to assess coordination at two levels of movement description based on observational kinematics. This study aims to describe the construct validity of the ILC2, according to the COSMIN (COnsensus-based Standards for the selection of health status Measurement INstruments) panel definition, assessing upper limb (UL) bimanual coordination in healthy individuals and in individuals with chronic stroke. Methodology: A cross-sectional study was conducted. Thirteen healthy individuals and 13 individuals who have had a stroke performed synchronous anti-phase forearm rotations for 10 seconds under 4 conditions: internally-paced self-paced (IP1), fast internally-paced (IP2), slow externally-paced (EP1), and fast externally-paced (EP2). Trunk, shoulder and elbow kinematics were recorded with an electromagnetic 9 sensor Polhemus system. Primary outcome measures (continuous relative phase, cross-correlation and lag) and secondary outcome measures (trunk and UL displacements and rotations) were compared to detect differences between groups using one-way analysis of variance (ANOVA) or repeated measure ANOVA. Between-group data were compared in a matched-speed condition in which frequency of arm rotation was similar. Based on the analysis, IP1 in the healthy group was compared to IP2 in the stroke group. To test the construct validity of the clinical ILC2, scores were correlated with primary and secondary outcome measures, scores on a similar test (Finger-To-Nose test); sensorimotor impairment scores at the Body function/structure level (Fugl-Meyer Assessment for the Upper Limb) and the Activity level (Chedoke Arm and Hand Activity Inventory) using Spearman correlation or Chi-square correlations. Results: Participants in both groups had similar sociodemographic characteristics. In the stroke group, participants had mild to moderate UL sensorimotor impairment and activity limitations, with no marked cognitive, sensory or proprioceptive deficits. Participants with stroke moved slower than healthy participants in all conditions, except EP1. Cross-correlation coefficient was lower (i.e. closer to 0) in the stroke group in the IP1 condition, but continuous relative phase and lag were similar between groups. In the IP1 condition, participants with stroke used more trunk rotation and shoulder abduction of the more-affected arm. In the matched-speed condition, participants with stroke used more trunk rotation and side-flexion and shoulder abduction of both arms, but less shoulder rotation of the more-affected arm compared to controls. In the stroke group, in the IP fast condition, ILC2 synchronicity and total scores were related to temporal coordination measure. ILC2 total score was also related to greater shoulder rotation of the more-affected arm. ILC2 score were not related to scores of clinical assessments.Conclusion: The ILC2, one of six tests in the CCS, is a valid measure of bimanual coordination in people with chronic stroke. Significance: The ILC2 may be used by clinicians to objectively assess UL bilateral coordination in individuals who have had a stroke, to help establish functional treatment goals and to monitor the effects of treatment interventions"--
This comprehensive edited treatise discusses the neurological, physiological, and cognitive aspects of interlimb coordination. It is unique in promoting a multidisciplinary perspective through introductory chapter contributions from experts in the neurosciences, experimental and developmental psychology, and kinesiology. Beginning with chapters defining the neural basis of interlimb coordination in animals, the book progresses toward an understanding of human locomotor control and coordination and the underlying brain structures and nerves that make such control possible. Section two focuses on the dynamics of interlimb coordination and the physics of movement. The final section presents information on how practice and experience affect coordination, including general skill acquisition, learning to walk, and the process involved in rhythmic tapping.
A number of movements produced in everyday life require not only coordination of joints within a limb, but also coordination between one or more limbs. The aim of this dissertation was to examine the influence of biomechanical constraints on intralimb coordination, interlimb coordination, and learning. Experiment 1 sought to determine if principles of the Leading Joint Hypothesis, when applied to a multijoint bimanual coordination task, could provide insight into the contribution of intralimb dynamics to interlimb coordination. Participants repetitively traced ellipse templates in an asymmetrical coordination pattern (i.e. both limbs moving counter-clockwise). Kinematic data of the upper limbs were recorded with a VICON camera system. Ellipse templates were oriented either tilted right or tilted left; yielding a total of four left arm-right arm leading joint combinations. The findings indicated that stability of interlimb coordination patterns were found to be influenced by whether arm movements were produced with similar or different leading joints. Bimanual asymmetric ellipse-tracing produced with similar leading joints were more stable than patterns produced with different leading joints. For example, asymmetric coordination patterns produced with similar leading joints exhibited less transient behavior than coordination patterns produced with different leading joints (p
Disability after stroke is a major burden on society, due to its high incidence and prevalence. Among the priorities of rehabilitation programs, stroke rehabilitation aims to regain independence and improve patients’ quality of life. Dynamic balance, falls prevention and upper limb recovery are essential features for the clinical management of hemiparetic patients. To optimize movement recovery after stroke, it is essential to select multilevel outcome measures for interpretation of motor recovery and clinical decision-making. In this context, the assessment of movement by means of quantitative movement analysis in hemiparetic post-stroke patients is key to planning rehabilitative intervention. Kinematic analysis facilitates interpreting the extent and mechanisms of motor restoration, and it has been increasingly applied in neurological research.
Previous literature has shown that there are substantial interlimb differences in coordination during unimanual movements. The dominant arm is typically more efficient in controlling intersegmental dynamics and the nondominant arm has an advantage for maintaining limb posture. Some have suggested that bimanual movements may involve different control strategies than those that are used during unimanual movements. Additionally, research has shown that interlimb differences are less when bimanually congruent joint displacement movements are completed compared to those completed that require congruent hand displacement. The purpose of this experiment was to observe if motor lateralization was affected during bilateral tasks. This was examined by comparing the coordination during unimanual and bimanual reaching movements. In this study, two hypotheses were proposed: 1) the effect of handedness would be reduced when moving bimanually compared to the movements made unimanually and 2) that bimanual movements that required congruent joint displacement would reflect less interlimb differences than those movements made with congruent hand displacement. Subjects were asked to make rapid and concise unimanual and bimanual movements to various targets, each of which had different inertial requirements. Bimanual movements consisted of those which require either congruent joint displacement or congruent hand displacement. Our results showed that interlimb differences in coordination were not changed under bimanual conditions. While we found some differences in coordination between joint congruent and hand congruent conditions, further comparison (outside of this current analysis) suggest that these differences persist during matched unimanual comparison, and therefore cannot be attributed to bimanual movement conditions. Based on our analysis, we suggest that the mechanisms which synchronize bimanual movements may occur upstream in the control process to the expression of motor lateralization and consequently, might not affect the expression of interlimb differences in coordination. This, in turn, indicates that bimanual coordination does not alter the mechanisms that determine intralimb coordination patterns. Additionally, our results challenged the conclusion of a difference in congruent joint displacement and congruent hand displacement movements; rather, the movements were similar in the amount of interlimb differences.
A Doody's Core Title 2012 Stroke Recovery and Rehabilitation is the new gold standard comprehensive guide to the management of stroke patients. Beginning with detailed information on risk factors, epidemiology, prevention, and neurophysiology, the book details the acute and long-term treatment of all stroke-related impairments and complications. Additional sections discuss psychological issues, outcomes, community reintegration, and new research. Written by dozens of acknowledged leaders in the field, and containing hundreds of tables, graphs, and photographic images, Stroke Recovery and Rehabilitation features: The first full-length discussion of the most commonly-encountered component of neurorehabilitation Multi-specialty coverage of issues in rehabilitation, neurology, PT, OT, speech therapy, and nursing Focus on therapeutic management of stroke related impairments and complications An international perspective from dozens of foremost authorities on stroke Cutting edge, practical information on new developments and research trends Stroke Recovery and Rehabilitation is a valuable reference for clinicians and academics in rehabilitation and neurology, and professionals in all disciplines who serve the needs of stroke survivors.