Anticipatory Planning of Functional Reach-to-Grasp

Abstract

Background. Intensive task-oriented training such as constraint-induced movement therapy (CIMT) is thought to engage motor learning and decision-making processes, including anticipatory action planning. Objective. To identify the effects of CIMT on anticipatory hand posture selection and movement time for task-specific reach-to-grasp performance. Methods. Subacute and chronic poststroke participants were recruited into CIMT (n = 10) or non-CIMT (n = 10) groups. Arm and hand functions were assessed before and after 2 weeks with the Wolf Motor Function Test (WMFT), Motor Activity Log (MAL), and a unique skilled reach-to-grasp task designed to test anticipatory hand posture selection. The reach-to-grasp tasks included power and precision grasping in 2 conditions achieved optimally with either a pronated (low difficulty) or supinated (high difficulty) hand posture. Outcome measures included success rate, frequency of optimal strategy selection, and movement time. Results. Between-group comparisons revealed a significant treatment effect for WMFT and MAL scores. The CIMT group showed larger gains in success rate, optimal posture selection (precision grasp only), and faster movement times for the supinated conditions. Conclusion. Together, a faster movement time and greater frequency of optimal hand posture selection in the more difficult task condition highlights a set of novel findings. These results provide evidence for training-induced improvements in upper-extremity function that support neurobehavioral recovery more than compensation. Although these findings are preliminary in view of the small sample size, the authors suggest that they may be useful to design and power larger-scale studies to further the understanding of the fundamental mechanisms induced by task-oriented training interventions in neurorehabilitation.

Motor and Visuospatial Attention and Motor Planning After Stroke: Considerations for the Rehabilitation of Standing Balance and Gait

“…15 Taking more time to plan a movement post-stroke is also associated with altered motor performance, such as reduced precision and coordination of the UE after stroke, 16,17 and the time required to plan an UE movement after stroke has been shown to decrease with rehabilitation. 17 Certain physical therapy treatments, such as constraint induced movement therapy, improve motor planning of the hand 18 and increase cortical blood flow in motor planning areas, 19 which may indicate active cortical reorganization with rehabilitation. Considering the oft-cited goals of improved standing balance and gait, and reducing falls after stroke, it is essential that we begin to consider the impact of altered motor planning on lower extremity (LE) movements.…”

The effects of post-stroke upper-limb training with an electromyography (EMG)-driven hand robot

“…Reorganization of surviving neural networks in the brain rather than repair of the damaged tissue is the key for motor functional restoration after stroke, which depends on repeated and intensive physical practice of the paretic limb on the motor skills to be restored (Lin et al, 2012(Lin et al, , 2009Miyai et al, 2006;Murata et al, 2006;Dijkhuizen et al, 2012;Takeuchi and Izumi, 2013). Therefore, physical training related to daily tasks has been widely adopted in post-stroke rehabilitation (Tan et al, 2012). Arm reaching practices associated with hand grasp and release movements are important for daily tasks.…”

Perceptuo-motor planning during functional reaching after stroke

“…Since 180° rotations may be challenging for individuals with stroke due to motor deficits, we chose to study the end-state effect of grasp height in this first study with individuals after stroke. End-state comfort based on orienting a dowel and rotating a card has also been used to evaluate treatment effects on the paretic arm in persons with chronic stroke (Tan et al 2012 ). Persons with stroke used a grasp posture consistent with the end-state comfort effect in most trials (68%), but less frequently than controls (91%).…”

“…The end-state comfort effect is reliably present only beyond the age of 9–10 years (Stockel et al 2012 ; Wunsch et al 2013 ) and declines with increasing age, which may be associated with reduced cognitive capabilities (Wunsch et al 2015 ). Studies investigating the end-state comfort effect in adult clinical populations are few (Rosenbaum et al 2012 ; Tan et al 2012 ) and how perceptuo-motor coupling may be affected by stroke has not been addressed.…”