Unraveling the interaction between pathological upper limb synergies and compensatory trunk movements during reach-to-grasp after stroke: a cross-sectional study

Abstract

The aim of the present study was to identify how pathological limb synergies between shoulder and elbow movements interact with compensatory trunk movements during a functional movement with the paretic upper limb after stroke. 3D kinematic joint and trunk angles were measured during a reach-to-grasp movement in 46 patients with stroke and 12 healthy individuals. We used principal component analyses (PCA) to identify components representing linear relations between the degrees of freedom of the upper limb and trunk across patients with stroke and healthy participants. Using multivariate logistic regression analysis, we investigated whether component scores were related to the presence or absence of basic limb synergies as indicated by the arm section of the Fugl-Meyer motor assessment (FMA). Four and three principal components were extracted in patients with stroke and healthy individuals, respectively. Visual inspection revealed that the contribution of joint and trunk angles to each component differed substantially between groups. The presence of the flexion synergy (Shoulder Abduction and Elbow Flexion) was reflected by component 1, whereas the compensatory role of trunk movements for lack of shoulder and elbow movements was reflected by components 2 and 3 respectively. The presence or absence of basic limb synergies as determined by means of the FMA was significantly related to components 2 (p = 0.014) and 3 (p = 0.003) in patients with stroke. These significant relations indicate that PCA is a useful tool to identify clinically meaningful interactions between compensatory trunk movements and pathological synergies in the elbow and shoulder during reach-to-grasp after stroke.

Detecting compensatory movements of stroke survivors using pressure distribution data and machine learning algorithms

“…1e). During the reaching motions, three types of compensatory synergies were commonly elicited, including an excessive axial trunk rotation (TR), trunk lean-forward (TLF) [33,34] and shoulder elevation movements (SE) [13,15]. Each subject performed the three types of reaching tasks with his/her affected side and healthy side.…”

Trunk Restraint to Promote Upper Extremity Recovery in Stroke Patients

“…Numerous studies have demonstrated that stroke patients exhibit excessive trunk movements during pointing and reaching, [6][7][8][9][10][11][12][13] a compensatory motor strategy to extend arm reach when shoulder and elbow movement and control is impaired. 14,15 Excessive use of compensatory movements can result in secondary complications such as muscle contractures, joint misalignment, pain, limb disuse, and increased energy expenditure.…”

The restoration of the shoulder joint function in the patients presenting with hemiparesis during the acute phase of hemispheric stroke

“…сенного церебрального инсульта представляет определенные трудности, и работы такого содержания в литературе встречаются относительно редко [16]. Необходимость в арсенале врача средств объективного анализа для больных, перенесших церебральный инсульт, весьма актуальна [17]. В последние годы такими средствами часто становятся инерционные сенсоры [17,18].…”

“…Необходимость в арсенале врача средств объективного анализа для больных, перенесших церебральный инсульт, весьма актуальна [17]. В последние годы такими средствами часто становятся инерционные сенсоры [17,18].…”