Precision aiming performance with the paretic upper limb is associated with center of pressure patterns in individuals with chronic stroke

People with stroke (PwS) often exhibit altered postural control, and concomitant stroke-related communication disorders (e.g., aphasia, dysarthria) may be an underrecognized risk factor for post-stroke falls. This heightened fall risk may be related to alterations in postural control that emerge during different speaking and listening conditions. This study evaluated how variations in the relative articulatory demands during speech production-termed "oral-motor complexity"-affect postural center of pressure (COP) patterns among PwS, both with communication disorders (PwS-CDis) and without (PwS). Three groups of adults (PwS, PwS-CDis, and a nondisabled Control group) stood on a force platform while completing four 30-second quiet stance trials, followed by twelve 30-second trials randomized across three experimental conditions of varying oral-motor complexities ("ba", "puh tuh kuh", "rah shah lah nah"). COP variability (SD) was significantly higher during experimental conditions compared to quiet stance, regardless of group and movement plane. Differences in nonlinear time-dependent metrics were found across oral-motor task conditions, particularly among PwS-CDis, suggesting oral-motor complexity may influence underlying postural-motor organization. Distinct temporal-dynamical patterns observed in PwS-CDis indicate a possible link between pathology, postural control, and speech motor tasks, which is relevant when evaluating postural control in individuals with stroke-related communication disorders.

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Influence of Impaired Upper Extremity Motor Function on Static Balance in People with Chronic Stroke

Mallo-López,

Cuesta-Gómez,

Fernández-Pardo

et al. 2024

Sensors

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Background: Stroke is a leading cause of disability, especially due to an increased fall risk and postural instability. The objective of this study was to analyze the impact of motor impairment in the hemiparetic UE on static balance in standing, in subject with chronic stroke. Methods: Seventy adults with chronic stroke, capable of independent standing and walking, participated in this cross-sectional study. The exclusion criteria included vestibular, cerebellar, or posterior cord lesions. The participants were classified based on their UE impairment using the Fugl-Meyer Assessment of Motor Recovery after Stroke (FMA-UE). A posturographic evaluation (mCTSIB) was performed in the standing position to analyze the center of pressure (COP) displacement in the mediolateral (ML) and anteroposterior (AP) axes and its mean speed with eyes open (OE) and closed (EC) on stable and unstable surfaces. Results: A strong and significant correlation (r = −0.53; p < 0.001) was observed between the mediolateral (ML) center of pressure (COP) oscillation and the FMA-UE, which was particularly strong with eyes closed [r(EO) = 0.5; r(EC) = 0.54]. The results of the multiple linear regression analysis indicated that the ML oscillation is influenced significantly by the FMA-Motor, and specifically by the sections on UE, wrist, coordination/speed, and sensation. Conclusions: The hemiparetic UE motor capacity is strongly related to the ML COP oscillation during standing in individuals with chronic stroke, with a lower motor capacity associated with a greater instability. Understanding these relationships underpins the interventions to improve balance and reduce falls in people who have had a stroke.

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Precision aiming performance with the paretic upper limb is associated with center of pressure patterns in individuals with chronic stroke

Cited by 3 publications

References 37 publications

Effects of Constraining Postural Sway During Upper-Limb Precision Aiming Task Practice in Individuals with Stroke

Effects of Constraining Postural Sway During Upper-Limb Precision Aiming Task Practice in Individuals with Stroke

Oral-motor complexity influences center of pressure patterns in adults with stroke-related communication disorders

Influence of Impaired Upper Extremity Motor Function on Static Balance in People with Chronic Stroke

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