title: Effect of auditory feedback differs according to side of hemiparesis: a comparative pilot study.
abstract: BACKGROUND
  Following stroke, patients frequently demonstrate loss of motor control and function and altered kinematic parameters of reaching movements. Feedback is an essential component of rehabilitation and auditory feedback of kinematic parameters may be a useful tool for rehabilitation of reaching movements at the impairment level. The aim of this study was to investigate the effect of 2 types of auditory feedback on the kinematics of reaching movements in hemiparetic stroke patients and to compare differences between patients with right (RHD) and left hemisphere damage (LHD).
  
  
  METHODS
  10 healthy controls, 8 stroke patients with LHD and 8 with RHD were included. Patient groups had similar levels of upper limb function. Two types of auditory feedback (spatial and simple) were developed and provided online during reaching movements to 9 targets in the workspace. Kinematics of the upper limb were recorded with an electromagnetic system. Kinematics were compared between groups (Mann Whitney test) and the effect of auditory feedback on kinematics was tested within each patient group (Friedman test).
  
  
  RESULTS
  In the patient groups, peak hand velocity was lower, the number of velocity peaks was higher and movements were more curved than in the healthy group. Despite having a similar clinical level, kinematics differed between LHD and RHD groups. Peak velocity was similar but LHD patients had fewer velocity peaks and less curved movements than RHD patients. The addition of auditory feedback improved the curvature index in patients with RHD and deteriorated peak velocity, the number of velocity peaks and curvature index in LHD patients. No difference between types of feedback was found in either patient group.
  
  
  CONCLUSIONS
  In stroke patients, side of lesion should be considered when examining arm reaching kinematics. Further studies are necessary to evaluate differences in responses to auditory feedback between patients with lesions in opposite cerebral hemispheres.
authors.affiliation: Laboratoire de Neurophysique et Physiologie, Université Paris Descartes, CNRS UMR 8119, Paris, France. johanna.robertson@parisdescartes.fr
authors.forename: Johanna V G
authors.initials: JV
authors.lastname: Robertson
authors.forename: Thomas
authors.initials: T
authors.lastname: Hoellinger
authors.forename: Påvel
authors.initials: P
authors.lastname: Lindberg
authors.forename: Djamel
authors.initials: D
authors.lastname: Bensmail
authors.forename: Sylvain
authors.initials: S
authors.lastname: Hanneton
authors.forename: Agnès
authors.initials: A
authors.lastname: Roby-Brami
mesh_terms: D000161:Acoustic Stimulation; D000328:Adult; D000368:Aged; D001132:Arm; D001307:Auditory Perception; D001696:Biomechanical Phenomena; D026241:Exercise Movement Techniques / Q000379:methods*; D030141:Feedback, Psychological; D005260:Female; D007839:Functional Laterality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D010291:Paresis / Q000209:etiology / Q000534:rehabilitation*; D010865:Pilot Projects; D011597:Psychomotor Performance; D020521:Stroke / Q000150:complications; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome