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Bimanual reach to grasp movements after cervical spinal cord injury

View Article: PubMed Central - PubMed

ABSTRACT

Injury to the cervical spinal cord results in bilateral deficits in arm/hand function reducing functional independence and quality of life. To date little research has been undertaken to investigate control strategies of arm/hand movements following cervical spinal cord injury (cSCI). This study aimed to investigate unimanual and bimanual coordination in patients with acute cSCI using 3D kinematic analysis as they performed naturalistic reach to grasp actions with one hand, or with both hands together (symmetrical task), and compare this to the movement patterns of uninjured younger and older adults. Eighteen adults with a cSCI (mean 61.61 years) with lesions at C4-C8, with an American Spinal Injury Association (ASIA) grade B to D and 16 uninjured younger adults (mean 23.68 years) and sixteen uninjured older adults (mean 70.92 years) were recruited. Participants with a cSCI produced reach-to-grasp actions which took longer, were slower, and had longer deceleration phases than uninjured participants. These differences were exacerbated during bimanual reach-to-grasp tasks. Maximal grasp aperture was no different between groups, but reached earlier by people with cSCI. Participants with a cSCI were less synchronous than younger and older adults but all groups used the deceleration phase for error correction to end the movement in a synchronous fashion. Overall, this study suggests that after cSCI a level of bimanual coordination is retained. While there seems to be a greater reliance on feedback to produce both the reach to grasp, we observed minimal disruption of the more impaired limb on the less impaired limb. This suggests that bimanual movements should be integrated into therapy.

No MeSH data available.


Related in: MedlinePlus

An example of a kinematic velocity profile for a participant with a cSCI (solid black line) and an uninjured young adult (dashed black line), in a unimanual condition (graphed between the start (0%) and the end of the movement (100%)) when the preferred/less impaired limb was reaching to the object.The cross markers show the average timing of peak velocity and the vertical lines how the start of the final adjustment phase. (cSCI = cervical Spinal Cord Injury).
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pone.0175457.g001: An example of a kinematic velocity profile for a participant with a cSCI (solid black line) and an uninjured young adult (dashed black line), in a unimanual condition (graphed between the start (0%) and the end of the movement (100%)) when the preferred/less impaired limb was reaching to the object.The cross markers show the average timing of peak velocity and the vertical lines how the start of the final adjustment phase. (cSCI = cervical Spinal Cord Injury).

Mentions: Markers were placed on the right and left medial styloid process, and the distal portion of the index finger and thumb, and recorded with a 5-camera motion analysis system (Proreflex, Qualysis, Sweden) sampling at 120Hz. Data were filtered using a low-pass Butterworth filter with a cut-off frequency of 10Hz [8,30], and were then analysed using Visual3D software (C-motion, USA). Kinematic landmarks were identified on the tangential velocity profiles (see Fig 1 for examples) using a custom-written program and confirmed by concurrent visual analyses of the velocity and displacement profiles.


Bimanual reach to grasp movements after cervical spinal cord injury
An example of a kinematic velocity profile for a participant with a cSCI (solid black line) and an uninjured young adult (dashed black line), in a unimanual condition (graphed between the start (0%) and the end of the movement (100%)) when the preferred/less impaired limb was reaching to the object.The cross markers show the average timing of peak velocity and the vertical lines how the start of the final adjustment phase. (cSCI = cervical Spinal Cord Injury).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5383293&req=5

pone.0175457.g001: An example of a kinematic velocity profile for a participant with a cSCI (solid black line) and an uninjured young adult (dashed black line), in a unimanual condition (graphed between the start (0%) and the end of the movement (100%)) when the preferred/less impaired limb was reaching to the object.The cross markers show the average timing of peak velocity and the vertical lines how the start of the final adjustment phase. (cSCI = cervical Spinal Cord Injury).
Mentions: Markers were placed on the right and left medial styloid process, and the distal portion of the index finger and thumb, and recorded with a 5-camera motion analysis system (Proreflex, Qualysis, Sweden) sampling at 120Hz. Data were filtered using a low-pass Butterworth filter with a cut-off frequency of 10Hz [8,30], and were then analysed using Visual3D software (C-motion, USA). Kinematic landmarks were identified on the tangential velocity profiles (see Fig 1 for examples) using a custom-written program and confirmed by concurrent visual analyses of the velocity and displacement profiles.

View Article: PubMed Central - PubMed

ABSTRACT

Injury to the cervical spinal cord results in bilateral deficits in arm/hand function reducing functional independence and quality of life. To date little research has been undertaken to investigate control strategies of arm/hand movements following cervical spinal cord injury (cSCI). This study aimed to investigate unimanual and bimanual coordination in patients with acute cSCI using 3D kinematic analysis as they performed naturalistic reach to grasp actions with one hand, or with both hands together (symmetrical task), and compare this to the movement patterns of uninjured younger and older adults. Eighteen adults with a cSCI (mean 61.61 years) with lesions at C4-C8, with an American Spinal Injury Association (ASIA) grade B to D and 16 uninjured younger adults (mean 23.68 years) and sixteen uninjured older adults (mean 70.92 years) were recruited. Participants with a cSCI produced reach-to-grasp actions which took longer, were slower, and had longer deceleration phases than uninjured participants. These differences were exacerbated during bimanual reach-to-grasp tasks. Maximal grasp aperture was no different between groups, but reached earlier by people with cSCI. Participants with a cSCI were less synchronous than younger and older adults but all groups used the deceleration phase for error correction to end the movement in a synchronous fashion. Overall, this study suggests that after cSCI a level of bimanual coordination is retained. While there seems to be a greater reliance on feedback to produce both the reach to grasp, we observed minimal disruption of the more impaired limb on the less impaired limb. This suggests that bimanual movements should be integrated into therapy.

No MeSH data available.


Related in: MedlinePlus