Measurement of bimanual coordination in rehabilitation for poststroke individuals: a systematic review

Abstract

A stroke can result in a decreased ability to coordinate the upper limbs, which leads to difficulty in performing the activities of daily living (ADLs). As a result, upper-extremity rehabilitation has been frequently implemented to improve impaired bimanual coordination. Many studies have examined the nature of bimanual coordination during two-handed discrete tasks such as reaching and grasping in many different populations. Over the past few decades, much research has been devoted to examining the nature of bimanual coordination. Foundational research examining bimanual coordination (i.e., inter-limb coordination) and control, has focused on how different constraints (e.g., task, individual) affect the degree and stability of spatial and temporal coupling between the end effectors or joints. This was done in the context of different philosophical paradigms, in the field of motor control and coordination, such as coordinative structures (Kugler et al., 1980), and synergies (Haken, 1983). However, in rehabilitation studies, the issue of bimanual coordination, along with the theoretical relevance of the emerging inferences have not been systematically addressed. Therefore, the first purpose of this project was to systematically review the methodological approaches used in the literature that examine changes in coordination and control in those who have had a stroke following upper-limb rehabilitation that aimed to improve bimanual function. Another objective was to classify these approaches in regards to their theoretical and conceptual basis. From this, suggestions were made as to how to potentially enhance the existing approaches to measuring inter-limb coordination during bimanual rehabilitation. [...]