Article

Better understanding of how bimanual coordination changes over the
first weeks of recovery after stroke is required to address the potential utility
for bimanual rehabilitation. Three-dimensional kinematic analysis can provide
quantitative assessment of unimanual and bimanual movements.
OBJECTIVE: To assess
the natural evolution of reaching kinematics during standard poststroke
rehabilitation, focusing on bimanual coordination. METHODS: A total of 12
hemiparetic, moderately impaired patients were included within 30 days after a
first unilateral ischemic/hemorrhagic stroke; 7 kinematic assessments were
performed once a week for 6 weeks and at 3 months after inclusion. The
reach-to-grasp task was performed in 3 different conditions: unimanual with the
healthy limb (UN), unimanual with the paretic limb (UP), and bimanual (BN/BP).
RESULTS: For the paretic limb, movement fluency (number of movement units and
total movement time) was lower for bimanual reaching compared with unimanual
reaching. For bimanual reaching, (1) movement kinematics were similar for both
limbs, (2) recovery patterns of both limbs followed a similar profile with a
plateau phase at 6 weeks poststroke, and (3) intertrial variability of
between-hands synchronization decreased over sessions, although the mean delays
remained the same. CONCLUSIONS: Bimanual coordination started to become efficient
6 weeks after onset of stroke, so for patients such as those we tested, this time
could be most opportune to start bimanual-oriented rehabilitation. The challenge
in future research includes determining the characteristics of patients who may
best benefit from bimanual therapy.

Langue : ANGLAIS