Effects of direction and index of difficulty on aiming movements after stroke

Paola Ribeiro Coqueiro, Sandra Maria Sbeghen Ferreira de Freitas, Cassandra Mendes Assunção e Silva, Sandra Regina Alouche, Paola Ribeiro Coqueiro, Sandra Maria Sbeghen Ferreira de Freitas, Cassandra Mendes Assunção e Silva, Sandra Regina Alouche

Abstract

Background: Brain hemispheres play different roles in the control of aiming movements that are impaired after unilateral stroke. It is not clear whether those roles are influenced by the direction and the difficulty of the task.

Objective: To evaluate the influence of direction and index of difficulty (ID) of the task on performance of ipsilesional aiming movements after unilateral stroke.

Methods: Ten individuals with right hemisphere stroke, ten with left hemisphere stroke, and ten age- and gender-matched controls performed the aiming movements on a digitizing tablet as fast as possible. Stroke individuals used their ipsilesional arm. The direction (ipsilateral or contralateral), size (0.8 or 1.6 cm), and distance (9 or 18 cm) of the targets, presented on a monitor, were manipulated and determined to be of different ID (3.5, 4.5, and 5.5). Results. Individuals with right hemisphere lesion were more sensitive to ID of the task, affecting planning and final position accuracy. Left hemisphere lesion generated slower and less smooth movements and was more influenced by target distance. Contralateral movements and higher ID increased planning demands and hindered movement execution.

Conclusion: Right and left hemisphere damages are differentially influenced by task constraints which suggest their complementary roles in the control of aiming movements.

Figures

Figure 1
Figure 1
(a) Participant's position. (b) Time course of each trial. (c) Targets position (gray circles) at a distance of 18 cm and 45° to the right and left of the initial position (IP, white circle).
Figure 2
Figure 2
Trajectory profile from a representative participant of each group with the right (R) and left (L) arms for the two targets (0.8 and 1.6 cm) and two distances from the initial position (9 and 18 cm) used in the experiment.
Figure 3
Figure 3
Mean reaction time (a) and mean time to peak of velocity (b) for the right (RC) and left (LC) arms of control group and ipsilesional arms of participants with right (RCVA) and left (LCVA) cerebrovascular accident for ipsilateral and contralateral movements for each index of difficulty (I = 3.5; II = 4.5; III = 4.5; IV = 5.5). Bars indicate standard error.
Figure 4
Figure 4
Mean values of movement time (a), peak of velocity (b), movement units (c), and variable error (d) for the right (RC) and left (LC) arms of control group and ipsilesional arms of participants with right (RCVA) and left (LCVA) cerebrovascular accident for ipsilateral and contralateral movements for each index of difficulty (I = 3.5; II = 4.5; III = 4.5; IV = 5.5). Bars indicate standard error.

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