Date of Award
Summer 2011
Document Type
Dissertation
Degree Name
Doctor of Philosophy (PhD)
Department
Biomedical Engineering
First Advisor
Schmit, Brian D.
Second Advisor
Scheidt, Robert A.
Third Advisor
Beardsley, Scott
Abstract
Deficits of the affected arm in people with post-stroke hemiparesis have been generally associated with decreased strength and increased spasticity. These deficits are varied in proximal (shoulder) and distal (elbow) joints which results in an overall impairment during movement or during stabilization of hand position in space. In this study, reaching of the hemiparetic arm in 3D workspace was characterized by a curved and non-smooth endpoint trajectory and a reduced functional range of motion, compared to the unimpaired arm. Smoother trajectories were observed in the acceleration phase more than the deceleration phase, which was common to both the stroke subjects and the neurologically intact controls. Decreased range of motion of the paretic arm in the proximal joint was associated with shoulder weakness, whereas limited range of motion in the elbow appeared to be due to increased antagonist muscle activation. In a task requiring subjects to stabilize their hand at different positions in space, arm weakness and movement synergy constraints may have contributed to stroke survivors generally decreasing the plane of elevation in order to maintain stable arm postures during movement and then stabilize the hand in space. The degree of decreased plane of elevation was negatively correlated with the Fugl-Meyer score. For a task when fine control movement was required simultaneously with a stable arm posture, stroke subjects demonstrated an inability to grade fine muscle control, resulting in larger range of the plane of elevation movements and larger endpoint error. These findings suggest that shoulder strength training might have important implications to the recovery of movement and ability to stabilize the hemiparetic arm during functional tasks.