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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.


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Group and limb means (±standard error) for Movement Time (MT) (a), Peak Velocity (PV) (b), proportion of movement time spent Decelerating (propDT) (c), proportion of movement time spent in Final Adjustment Phase (propFAP) (d) for unimanual (grey) and bimanual (white) conditions.(* denotes significant difference between conditions and ‡ represents a significant difference between groups), (cSCI_LI = cervical Spinal Cord Injury less impaired limb, cSCI_MI = cervical Spinal Cord Injury more impaired limb, YA_P = non-injured younger adults preferred limb, YA_NP = non-injured younger adults non-preferred limb, OA_P = non-injured older adults preferred limb, OA_NP = non-injured older adults non-preferred limb).
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pone.0175457.g002: Group and limb means (±standard error) for Movement Time (MT) (a), Peak Velocity (PV) (b), proportion of movement time spent Decelerating (propDT) (c), proportion of movement time spent in Final Adjustment Phase (propFAP) (d) for unimanual (grey) and bimanual (white) conditions.(* denotes significant difference between conditions and ‡ represents a significant difference between groups), (cSCI_LI = cervical Spinal Cord Injury less impaired limb, cSCI_MI = cervical Spinal Cord Injury more impaired limb, YA_P = non-injured younger adults preferred limb, YA_NP = non-injured younger adults non-preferred limb, OA_P = non-injured older adults preferred limb, OA_NP = non-injured older adults non-preferred limb).

Mentions: In comparison to the unimanual task, all participants (cSCI and UP) took longer to complete the bimanual reach-to-grasp task [F(1,46) = 7.58, p<0.01, η2 = 0.14] (Fig 2a). Furthermore, a longer period of deceleration (PropDT) [F(1,43) = 23.64, p<0.001, η2 = 0.36] and final adjustment (propFAP) [F(1,43) = 7.93, p<0.01, η2 = 0.16] were also noted for bimanual tasks. Fig 2a clearly shows that participants with a cSCI produced movements which were significantly longer in duration than UP (YA and OA) [F(2,46) = 27.62, p<0.001, η2 = 0.55] and reached a significantly lower PV than YA [F(2,43) = 9.89, p<0.001, η2 = 0.32] (Fig 2b). Participants with a cSCI also had a longer PropDT than UP (YA and OA) [F(2,43) = 19.94, p<0.001, η2 = 0.48] (Fig 2c). Differences in PropFAP [F(2,43) = 7.01, p<0.01, η2 = 0.25] were noted between the YA and the cSCI group with no significant difference between cSCI and OA (Fig 2d). There was no significant main effect of limb for MT, PV, PropDT or PropFAP (p>0.05).


Bimanual reach to grasp movements after cervical spinal cord injury
Group and limb means (±standard error) for Movement Time (MT) (a), Peak Velocity (PV) (b), proportion of movement time spent Decelerating (propDT) (c), proportion of movement time spent in Final Adjustment Phase (propFAP) (d) for unimanual (grey) and bimanual (white) conditions.(* denotes significant difference between conditions and ‡ represents a significant difference between groups), (cSCI_LI = cervical Spinal Cord Injury less impaired limb, cSCI_MI = cervical Spinal Cord Injury more impaired limb, YA_P = non-injured younger adults preferred limb, YA_NP = non-injured younger adults non-preferred limb, OA_P = non-injured older adults preferred limb, OA_NP = non-injured older adults non-preferred limb).
© Copyright Policy
Related In: Results  -  Collection

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

pone.0175457.g002: Group and limb means (±standard error) for Movement Time (MT) (a), Peak Velocity (PV) (b), proportion of movement time spent Decelerating (propDT) (c), proportion of movement time spent in Final Adjustment Phase (propFAP) (d) for unimanual (grey) and bimanual (white) conditions.(* denotes significant difference between conditions and ‡ represents a significant difference between groups), (cSCI_LI = cervical Spinal Cord Injury less impaired limb, cSCI_MI = cervical Spinal Cord Injury more impaired limb, YA_P = non-injured younger adults preferred limb, YA_NP = non-injured younger adults non-preferred limb, OA_P = non-injured older adults preferred limb, OA_NP = non-injured older adults non-preferred limb).
Mentions: In comparison to the unimanual task, all participants (cSCI and UP) took longer to complete the bimanual reach-to-grasp task [F(1,46) = 7.58, p<0.01, η2 = 0.14] (Fig 2a). Furthermore, a longer period of deceleration (PropDT) [F(1,43) = 23.64, p<0.001, η2 = 0.36] and final adjustment (propFAP) [F(1,43) = 7.93, p<0.01, η2 = 0.16] were also noted for bimanual tasks. Fig 2a clearly shows that participants with a cSCI produced movements which were significantly longer in duration than UP (YA and OA) [F(2,46) = 27.62, p<0.001, η2 = 0.55] and reached a significantly lower PV than YA [F(2,43) = 9.89, p<0.001, η2 = 0.32] (Fig 2b). Participants with a cSCI also had a longer PropDT than UP (YA and OA) [F(2,43) = 19.94, p<0.001, η2 = 0.48] (Fig 2c). Differences in PropFAP [F(2,43) = 7.01, p<0.01, η2 = 0.25] were noted between the YA and the cSCI group with no significant difference between cSCI and OA (Fig 2d). There was no significant main effect of limb for MT, PV, PropDT or PropFAP (p>0.05).

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