PTOTOtherNeurorehabilitation and neural repair2022

Assessing Impairments in Visuomotor Adaptation After Stroke.

Robert T Moore, Mark A Piitz, Nishita Singh and 2 others

PMID 35616370

WHAT IT FOUND

Stroke survivors adapt less to visual errors and need more practice than controls.

Those with dominant-arm damage struggle most. Adaptation scores correlate with Fugl-Meyer and FIM, but clinical scales miss half the deficits, so motor learning issues may exist despite normal functional scores.

Key findings

01Participants with stroke showed reduced final adaptation and required significantly more trials to adapt compared to controls.

02Individuals with dominant-arm stroke had lower final adaptation scores than those with non-dominant-arm stroke and controls.

03Final adaptation correlated with motor impairment (FMA-UE) and functional independence (FIM), but initial adaptation and trials-to-adapt did not.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTs

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What it does not show

The study was cross-sectional, so it cannot track how adaptation changes over time during recovery. The sample size was small (36 stroke participants), limiting the generalizability of the findings. Most participants had mild to moderate impairment, so results may not apply to those with severe motor deficits. There was a limited number of left-handed participants, making it difficult to generalize findings on arm dominance. The study did not test interventions, so it is unknown if addressing these adaptation deficits improves functional outcomes.

Declared interests

The authors declared no conflicts of interest. The study was funded by the Canadian Institutes of Health Research, the Faculty of Kinesiology, and the Calgary Health Trust.

The easy way to misread this

Do not assume that a patient's ability to adapt to movement errors is captured by standard clinical scores. A patient can have a normal FIM score and still fail to adapt to visual distortions, which may hinder their ability to learn new motor strategies.

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