Relationships between sensorimotor impairments and reaching deficits in acute hemiparesis.
OBJECTIVE
To determine the relationships between sensorimotor impairments and upper extremity reaching performance during the acute phase of stroke and to determine which, if any, measures of sensorimotor impairment can predict variance in reaching performance during this phase.


METHODS
Sensorimotor impairments of upper extremity (UE) strength, active range of motion, isolated movement control, light touch sensation, joint position sense, spasticity, and shoulder pain were evaluated in a group of 46 individuals with acute hemiparesis (mean time since insult = 9.2 days). Subjects performed a reaching task to a target placed on their affected side. Three-dimensional kinematic analyses were used to assess reaching speed, accuracy, and efficiency. Forward stepwise multiple linear regression analyses were used to determine which impairment was the best predictor of variance in reaching performance.


RESULTS
Measures of UE strength predicted the largest proportion of variance in the speed, accuracy, and efficiency of forward reaching. Isolated movement control, somatosensory deficits, and elbow spasticity predicted smaller amounts of variance in reaching performance.


CONCLUSIONS
The authors' data show that deficits in strength appear to be the most influential sensorimotor impairment associated with limited reaching performance in subjects with acute hemiparesis.
Wagner
Joanne M
JM
Program in Physical Therapy, Washington University School of Medicine, St. Louis, MO 63108, USA.
Lang
Catherine E
CE
Sahrmann
Shirley A
SA
Hu
Qungli
Q
Bastian
Amy J
AJ
Edwards
Dorothy F
DF
Dromerick
Alexander W
AW
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001132:Arm / Q000503:physiopathology*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010291:Paresis / Q000209:etiology / Q000503:physiopathology*; D011596:Psychomotor Disorders / Q000209:etiology / Q000503:physiopathology*; D020886:Somatosensory Disorders / Q000209:etiology / Q000503:physiopathology*; D020521:Stroke / Q000150:complications / Q000503:physiopathology*; D013647:Task Performance and Analysis