Interaction in Bilaterally Simultaneous Voluntary Motor Function

Abstract

IT IS NOW well recognized in the sphere of sensory perception that percepts as determined by a single stimulus may be altered, or even obliterated, when disparate multiple stimuli are simultaneously applied to various regions of the soma.1 This phenomenon has been demonstrated most clearly in the modalities of vision, audition and general cutaneous sensory function.It has also been observed that under certain conditions a unilateral Babinski sign can be obliterated with bilateral simultaneous plantar stimulation 2; occasionally bilateral simultaneous plantar stimulation is also seen to enhance a weak or equivocal unilateral Babinski sign.In the sphere of voluntary executive function interaction influences have not yet been specifically demonstrated. The purpose of this presentation is to show that interaction in the motor sphere does occur and can be demonstrated by suitable means.Succession movements, or the diadokokinetic action of Babinski,3 lend themselves admirably to the study of motor interaction. It was clinically observed that certain patients with hemiparesis who had diminished supination-pronation ability on the involved side often showed impaired supination-pronation movements of the intact side when these actions were executed simultaneously on the two sides. This effect was particularly well brought out when the patient was exhorted to operate at maximum speed of alternation and when the patient had a desire to excel ! The primary major effect of bilateral simultaneous supination-pronation action was to decrease the ability of the intact side to perform with the facility that was evident when the intact side alone was set into operation. PRESENT INVESTIGATION In order to make relatively precise observations of this phenomenon, two methods of study were employed. One was by means of motion picture photography; the other, by means of a photocell transducer system operating into an ink-writing oscillograph. The latter system was eminently practical because of the simplicity and the definition of its output. A schematic diagram of the photocell system is shown in figure 1.

Bimanual coordination: A missing piece of arm rehabilitation after stroke

“…This recognition, driven through the tenets of the dynamical systems theory, led to a substantial body of literature that determined the effects of symmetrical independent-goal bimanual movements on the performance of the paretic arm in patients with stroke. As early as 1951, Cohn reported that movement of the weaker side reduced the frequency of the unimpaired forearm during bilateral continuous pronation-supination movements (Cohn et al, 1951). These findings, in addition to subsequent studies using an elbow flexion-extension task (Cunningham, Stoykov, & Walter, 2002), continuous circle drawing task (Lewis & Byblow, 2004), bimanual reaching task (McCombe Waller, Harris-Love, Liu, & Whitall, 2006; Rose & Winstein, 2005) and bilateral reach-to-grasp tasks (Mudie & Matyas, 2000) indicate that despite unimanual weakness, patients demonstrate a capability to retain spatial and temporal coupling between the two UEs.…”

Bimanual coordination: A missing piece of arm rehabilitation after stroke

“…This recognition, driven through the tenets of the dynamical systems theory, led to a substantial body of literature that determined the effects of symmetrical independent-goal bimanual movements on the performance of the paretic arm in patients with stroke. As early as 1951, Cohn reported that movement of the weaker side reduced the frequency of the unimpaired forearm during bilateral continuous pronation-supination movements (Cohn et al, 1951). These findings, in addition to subsequent studies using an elbow flexion-extension task (Cunningham, Stoykov, & Walter, 2002), continuous circle drawing task (Lewis & Byblow, 2004), bimanual reaching task (McCombe Waller, Harris-Love, Liu, & Whitall, 2006; Rose & Winstein, 2005) and bilateral reach-to-grasp tasks (Mudie & Matyas, 2000) indicate that despite unimanual weakness, patients demonstrate a capability to retain spatial and temporal coupling between the two UEs.…”

Bimanual coordination: A missing piece of arm rehabilitation after stroke

“…This recognition, driven through the tenets of the dynamical systems theory, led to a substantial body of literature that determined the effects of symmetrical independent-goal bimanual movements on the performance of the paretic arm in patients with stroke. As early as 1951, Cohn reported that movement of the weaker side reduced the frequency of the unimpaired forearm during bilateral continuous pronation-supination movements (Cohn et al, 1951). These findings, in addition to subsequent studies using an elbow flexion-extension task (Cunningham, Stoykov, & Walter, 2002), continuous circle drawing task (Lewis & Byblow, 2004), bimanual reaching task (McCombe Waller, Harris-Love, Liu, & Whitall, 2006; Rose & Winstein, 2005) and bilateral reach-to-grasp tasks (Mudie & Matyas, 2000) indicate that despite unimanual weakness, patients demonstrate a capability to retain spatial and temporal coupling between the two UEs.…”

Bimanual coordination: A missing piece of arm rehabilitation after stroke

“…This recognition, driven through the tenets of the dynamical systems theory, led to a substantial body of literature that determined the effects of symmetrical independent-goal bimanual movements on the performance of the paretic arm in patients with stroke. As early as 1951, Cohn reported that movement of the weaker side reduced the frequency of the unimpaired forearm during bilateral continuous pronation-supination movements (Cohn et al, 1951). These findings, in addition to subsequent studies using an elbow flexion-extension task (Cunningham, Stoykov, & Walter, 2002), continuous circle drawing task (Lewis & Byblow, 2004), bimanual reaching task (McCombe Waller, Harris-Love, Liu, & Whitall, 2006; Rose & Winstein, 2005) and bilateral reach-to-grasp tasks (Mudie & Matyas, 2000) indicate that despite unimanual weakness, patients demonstrate a capability to retain spatial and temporal coupling between the two UEs.…”