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

MedStar author(s):
Citation: Neurorehabilitation & Neural Repair. 37(4):183-193, 2023 04.PMID: 37067001Institution: MedStar National Rehabilitation NetworkForm of publication: Journal ArticleMedline article type(s): Journal Article | Research Support, U.S. Gov't, Non-P.H.S.Subject headings: *Stroke | *Stroke Rehabilitation | Arm | Humans | Movement | Stroke/co [Complications] | Survivors | Year: 2023Local holdings: Available online from MWHC library: 2006 - 2009, Available in print through MWHC library: 1999 - March 2006ISSN:
  • 1545-9683
Name of journal: Neurorehabilitation and neural repairAbstract: 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?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.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.OBJECTIVE: We sought to elucidate the impact of energetic cost and task success on the arm choice of stroke survivors.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.All authors: Lee SW, Nguyen H, Phan T, Shadmehr RFiscal year: FY2023Digital Object Identifier: Date added to catalog: 06/01/2023
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Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 37067001 Available 37067001

Available online from MWHC library: 2006 - 2009, Available in print through MWHC library: 1999 - March 2006

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?

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.

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.

OBJECTIVE: We sought to elucidate the impact of energetic cost and task success on the arm choice of stroke survivors.

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.

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