Choice of Arm Use in Stroke Survivors is Largely Driven by the Energetic Cost of the Movement. 

 -  2023 
<br/><br/>Available online from MWHC library: 2006 - 2009, Available in print through MWHC library: 1999 - March 2006 
<br/><br/> BACKGROUND: The decision of which arm to use to achieve a goal depends on energetic costs and performance abilities of each arm. Following a stroke, there is a reduction in the use of the more-impaired arm. Is it because the energetic costs of the more-impaired arm are increased, or because its use dictates a lower chance of success?  CONCLUSIONS: The impact of energetic cost on arm choice of stroke survivors is greater than neurologically-intact subjects. Thus, the reduction in the use of the impaired arm following stroke may be primarily due to a subjective increase in the effort it takes to use that arm.  METHODS: Thirteen chronic stroke survivors and thirteen neurologically-intact subjects participated in an experiment where they reached towards visual targets in a virtual-reality environment. Energetic cost of reaching with their less-used arm (nondominant/more-impaired) was adjusted by amplifying the range of motion, while task accuracy requirement was independently modulated by changing target size.  OBJECTIVE: We sought to elucidate the impact of energetic cost and task success on the arm choice of stroke survivors.  RESULTS: Reducing the energic cost of reaching increased the use of the less-used arms in both groups, but by a greater amount in the stroke survivors. In contrast, lowering task accuracy requirement altered arm choice similarly in the two groups. The time spent in decision-making (reaction time) reflected different impacts of energetic cost and task success on the arm choice of the two groups. Conversely, velocity changes were similar between the groups. 
<br/><br/><br/>English 
<br/><br/><label>ISSN: </label>1545-9683 
<br/><br/><label>Standard No.: </label>10.1177/15459683231164788 [doi] 
<br/><br/><label>Subjects--Topical Terms: </label><br/>*Stroke<br/>*Stroke Rehabilitation<br/>Arm<br/>Humans<br/>Movement<br/>Stroke/co [Complications]<br/>Survivors--Automated
<br/><br/><label>Subjects--Geographic Terms: </label><br/>MedStar National Rehabilitation Network
<br/><br/><label>Index Terms--Function: </label><br/>Journal Article<br/>Research Support, U.S. Gov't, Non-P.H.S.