Force control and degree of motor impairments in chronic stroke

Objective: This study determined the variability and regularity of force production in impaired upper extremities of chronic stroke survivors. Two hypotheses included: (1) stroke will increase the variability and regularity of force output in comparison to age-matched controls and (2) degree of motor impairments will be positively correlated with the variability and regularity of force output. Methods: Nine chronic stroke and nine age-matched controls performed unimanual isometric wrist and finger extension movements for 20 s to three different target force levels. Force output was indexed by magnitude, accuracy, variability, and regularity. Stroke motor impairment levels were determined by Fugl-Meyer upper extremity assessment. Results: The stroke group demonstrated increased variability and regularity of the force output. Further, motor impairments scaled with increase in variability and regularity of force output. Conclusions: The variability and regularity of force differentiated isometric contractions performed by chronic stroke survivors from age-matched controls. Moreover, in clinical settings an objective assessment of force control on variability and regularity appears to be most meaningful at 25% of MVC. Significance: Increased variability contributes to reduced steadiness in force output. Increased regularity characterizes the adaptability losses in motor capabilities following stroke. This knowledge may facilitate planning and evaluating rehabilitation protocols. (C) 2010 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.