Influence of Task on Interlimb Coordination in Adults with Cerebral Palsy

Overview

Journal Arch Phys Med Rehabil

Specialty Rehabilitation Medicine

Date 2010 Sep 30

PMID 20875516

Citations 4

Authors

Jeanne Langan

Stephen T Doyle

Edward A Hurvitz

Susan H Brown

Affiliations

Soon will be listed here.

Abstract

Objective: To examine movement time and kinematic properties of unilateral and bilateral reaching movements in adults with cerebral palsy (CP), focusing on how different types of bilateral movements, simultaneous or sequential, may influence interlimb coordination.

Design: Quantitative study using between-group repeated-measures analyses.

Setting: Motor control laboratory at a research university.

Participants: Adults with hemiplegic CP (n=11; mean age ± SD, 33±10y; 4 men) and age-matched controls (mean age ± SD, 32±9y; 4 men).

Interventions: Not applicable.

Main Outcome Measures: Movement time (MT), maximum deviation from a straight trajectory to the target, and peak speed.

Results: Although adults with hemiplegic CP showed strong unilateral deficits, bilateral simultaneous reaching movements were temporally and spatially coupled. Movement of the less affected arm slowed to match the movement of the more affected arm. In contrast, bilateral sequential movements improved MTs of the less affected and more affected arms.

Conclusions: Bilateral sequential movements were conducive to faster MT compared with unilateral or bilateral simultaneous movements. Training that includes bilateral sequential movements may be beneficial to adults with hemiplegic CP. Upper-limb movements are coordinated in a variety of ways to perform routine bilateral tasks. Some bilateral tasks, such as stacking boxes, require more symmetric movements of the upper limbs. Other bilateral tasks, such as opening the refrigerator with 1 hand while placing an item on the shelf with the other hand, emphasize coordinated sequential action between upper limbs. Despite the prevalence of integrative upper-limb use, the control of different forms of bilateral movement is not well understood. A more comprehensive knowledge of upper-limb bilateral movements may hold important implications for developing more effective upper-limb movement therapies.

Citing Articles

Exploring the Link Between Motor Functions and the Relative Use of the More Affected Arm in Adults with Cerebral Palsy.

Poitras I, Clouatre J, Campeau-Lecours A, Mercier C Sensors (Basel). 2025; 25(3).

PMID: 39943298 PMC: 11819957. DOI: 10.3390/s25030660.

Robotic assessment of bilateral and unilateral upper limb functions in adults with cerebral palsy.

Poitras I, Dukelow S, Campeau-Lecours A, Mercier C J Neuroeng Rehabil. 2024; 21(1):144.

PMID: 39169408 PMC: 11340066. DOI: 10.1186/s12984-024-01415-9.

A systematic review of instrumented assessments for upper limb function in cerebral palsy: current limitations and future directions.

Rozaire J, Paquin C, Henry L, Agopyan H, Bard-Pondarre R, Naaim A J Neuroeng Rehabil. 2024; 21(1):56.

PMID: 38622731 PMC: 11020208. DOI: 10.1186/s12984-024-01353-6.

Upper extremity asymmetry due to nerve injuries or central neurologic conditions: a scoping review.

Bhat S, Shin A, Kaufman K J Neuroeng Rehabil. 2023; 20(1):151.

PMID: 37940959 PMC: 10634143. DOI: 10.1186/s12984-023-01277-7.

Upper limb kinematics of adults with cerebral palsy on bilateral functional tasks.

Lott C, Johnson M Annu Int Conf IEEE Eng Med Biol Soc. 2017; 2016:5676-5679.

PMID: 28269543 PMC: 11774504. DOI: 10.1109/EMBC.2016.7592015.

References

Luft A, McCombe-Waller S, Whitall J, Forrester L, Macko R, Sorkin J . Repetitive bilateral arm training and motor cortex activation in chronic stroke: a randomized controlled trial. JAMA. 2004; 292(15):1853-61. PMC: 2930817. DOI: 10.1001/jama.292.15.1853. View

Feys H, Eyssen M, Jaspers E, Klingels K, Desloovere K, Molenaers G . Relation between neuroradiological findings and upper limb function in hemiplegic cerebral palsy. Eur J Paediatr Neurol. 2009; 14(2):169-77. DOI: 10.1016/j.ejpn.2009.01.004. View

Cramer S, Nelles G, BENSON R, Kaplan J, Parker R, Kwong K . A functional MRI study of subjects recovered from hemiparetic stroke. Stroke. 1997; 28(12):2518-27. DOI: 10.1161/01.str.28.12.2518. View

Nazzal M, Saadah M, Saadah L, Trebinjac S . Acute ischemic stroke: relationship of brain lesion location & functional outcome. Disabil Rehabil. 2009; 31(18):1501-6. DOI: 10.1080/09638280802627702. View

Utley A, Sugden D . Interlimb coupling in children with hemiplegic cerebral palsy during reaching and grasping at speed. Dev Med Child Neurol. 1998; 40(6):396-404. View

Kelso J, Southard D, Goodman D . On the nature of human interlimb coordination. Science. 1979; 203(4384):1029-31. DOI: 10.1126/science.424729. View

Swinnen S . Intermanual coordination: from behavioural principles to neural-network interactions. Nat Rev Neurosci. 2002; 3(5):348-59. DOI: 10.1038/nrn807. View

Hurvitz E, Conti G, Brown S . Changes in movement characteristics of the spastic upper extremity after botulinum toxin injection. Arch Phys Med Rehabil. 2003; 84(3):444-54. DOI: 10.1053/apmr.2003.50001. View

Swinnen S, Jardin K, Verschueren S, Meulenbroek R, Franz L, Dounskaia N . Exploring interlimb constraints during bimanual graphic performance: effects of muscle grouping and direction. Behav Brain Res. 1998; 90(1):79-87. DOI: 10.1016/s0166-4328(97)00083-1. View

10.

Franz E, Zelaznik H, McCabe G . Spatial topological constraints in a bimanual task. Acta Psychol (Amst). 1991; 77(2):137-51. DOI: 10.1016/0001-6918(91)90028-x. View

11.

Carson R, Goodman D, Kelso J, Elliott D . Phase Transitions and Critical Fluctuations in Rhythmic Coordination of Ipsilateral Hand and Foot. J Mot Behav. 1995; 27(3):211-224. DOI: 10.1080/00222895.1995.9941711. View

12.

Bongaardt R, Meijer O . Bernstein's theory of movement behavior: historical development and contemporary relevance. J Mot Behav. 2000; 32(1):57-71. DOI: 10.1080/00222890009601360. View

13.

McCombe Waller S, Liu W, Whitall J . Temporal and spatial control following bilateral versus unilateral training. Hum Mov Sci. 2008; 27(5):749-58. DOI: 10.1016/j.humov.2008.03.006. View

14.

Harris-Love M, Waller S, Whitall J . Exploiting interlimb coupling to improve paretic arm reaching performance in people with chronic stroke. Arch Phys Med Rehabil. 2005; 86(11):2131-7. DOI: 10.1016/j.apmr.2005.05.006. View

15.

Cauraugh J, Coombes S, Lodha N, Naik S, Summers J . Upper extremity improvements in chronic stroke: coupled bilateral load training. Restor Neurol Neurosci. 2009; 27(1):17-25. PMC: 2752408. DOI: 10.3233/RNN-2009-0455. View

16.

Goble D . The potential for utilizing inter-limb coupling in the rehabilitation of upper limb motor disability due to unilateral brain injury. Disabil Rehabil. 2006; 28(18):1103-8. DOI: 10.1080/09638280500526537. View

17.

Taub E . Constraint-induced movement therapy and massed practice. Stroke. 2000; 31(4):986-8. DOI: 10.1161/01.str.31.4.983-c. View

18.

Pigeon P, Bortolami S, DiZio P, Lackner J . Coordinated turn-and-reach movements. I. Anticipatory compensation for self-generated coriolis and interaction torques. J Neurophysiol. 2003; 89(1):276-89. DOI: 10.1152/jn.00159.2001. View

19.

Swinnen S, Wenderoth N . Two hands, one brain: cognitive neuroscience of bimanual skill. Trends Cogn Sci. 2003; 8(1):18-25. DOI: 10.1016/j.tics.2003.10.017. View

20.

Feydy A, Carlier R, Roby-Brami A, Bussel B, Cazalis F, Pierot L . Longitudinal study of motor recovery after stroke: recruitment and focusing of brain activation. Stroke. 2002; 33(6):1610-7. DOI: 10.1161/01.str.0000017100.68294.52. View