Transient changes in paretic and non-paretic isometric force control during bimanual submaximal and maximal contractions.
Hyun Joon Kim, Nyeonju Kang, James H Cauraugh
PMID 32410626WHAT IT FOUND
During maximal bimanual wrist and finger extension, the paretic arm produced greater sustained force than unimanual.
During submaximal tasks, bimanual conditions made force output less steady and more repetitive in both arms, with more change in the non-paretic arm.
Key findings
01During maximal sustained force production, the paretic arm produced greater force in the bimanual condition than in the unimanual condition, while the non-paretic arm produced less force.
02During submaximal force control, bimanual conditions increased force variability and made force output more repetitive in both arms, with greater change in the non-paretic arm.
03At submaximal levels, the two arms produced comparable mean force in the bimanual condition, while the non-paretic arm showed larger increases in variability and regularity.
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
Only 14 patients with stroke were studied. Participants were at least 6 months after stroke and had to move the wrist and fingers through a specified range and score above 23 on a cognitive screen, so it may not apply to very early, very impaired, or cognitively impaired stroke patients. The outcomes were one-session isometric force measures, not training effects or daily function. Prior bimanual training or rehabilitation experience was not controlled. Results were limited to wrist and finger extension and may not apply to hand grip or elbow extension. Submaximal tasks used constant visual feedback, which may have affected force control.
Declared interests
Incheon National University funded the work. The supplied text does not report author conflict-of-interest disclosures.
The easy way to misread this
Do not conclude that bimanual training improves stroke arm recovery. This study tested one session of isometric force tasks, and at submaximal levels bimanual force output became less steady and more repetitive rather than better controlled.