The Impact of Shoulder Abduction Loading on Volitional Hand Opening and Grasping in Chronic Hemiparetic Stroke

Yiyun Lan, Jun Yao, Julius P.A. Dewald*

*Corresponding author for this work

Research output: Contribution to journalArticle

22 Scopus citations

Abstract

Background. Up to 60% of individuals with moderate to severe chronic hemiparetic stroke experience excessive involuntary wrist/finger flexion that constrains functional hand movements including hand opening. It's not known how stroke-induced brain injury impacts volitional hand opening and grasping forces as a result of the expression of abnormal coupling between shoulder abduction and wrist/finger flexion or the flexion synergy. Objective. The goal of this study is to understand how shoulder abduction loading affects volitional hand opening and grasping forces in individuals with moderate to severe chronic hemiparetic stroke. Methods. Thirty-six individuals (stroke, 26; control, 10) were recruited for this study. Each participant was instructed to perform maximal hand opening and grasping forces while the arm was either fully supported or lifted with a weight equal to 25% or 50% of the participant's maximal shoulder abduction torque. Hand pentagon area, defined as the area formed by the tips of thumb and fingers, was calculated during hand opening. Forces were recorded during grasping. Results. In individuals with moderate stroke, increasing shoulder abduction loading reduced the ability to maximally open the hand. In individuals with severe stroke, who were not able to open the hand, grasping forces were generated and increased with shoulder abduction loading. Stroke individuals also showed a reduced ability to control volitional grasping forces due to the enhanced expression of flexion synergy. Conclusions. Shoulder abduction loading reduced the ability to volitionally open the hand and control grasping forces after stroke. Neural mechanisms and clinical implications of these findings are discussed.

Original languageEnglish (US)
Pages (from-to)521-529
Number of pages9
JournalNeurorehabilitation and Neural Repair
Volume31
Issue number6
DOIs
StatePublished - Jun 1 2017

Keywords

  • flexion synergy
  • grasping forces
  • hand opening
  • loss of independent joint control
  • motor control
  • muscle coactivation
  • paretic hand dysfunction
  • reticulospinal tract
  • shoulder abduction
  • stroke rehabilitation

ASJC Scopus subject areas

  • Rehabilitation
  • Neurology
  • Clinical Neurology

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