Bilateral coupling facilitates recovery of rhythmical movements from perturbation in healthy and post-stroke subjects

The paretic arm of subjects with stroke has a decreased ability to quickly adapt to and recover from perturbations during rhythmical arm swinging. We investigated whether bilateral coupling in the synchronous motion of two arms may facilitate the restoration of rhythmical movement of the paretic arm in subjects with chronic hemiparesis due to stroke. While standing, stroke and age-matched healthy (control) subjects swung one or both arms synchronously at ~0.8 Hz from the shoulder joints. In randomly selected cycles, one arm was transiently arrested by an electromagnetic device when moving forward or backward. In the control group, bilateral swinging resumed faster than unilateral swinging regardless of which arm was perturbed. In the stroke group, this effect was observed only when the perturbation was applied to the paretic arm, suggesting that the motion of the non-paretic arm accelerated the recovery from perturbation of the paretic arm. In addition, bilateral swinging resumed after reduced anterior-posterior excursions of both arms in stroke subjects. Results confirm previous findings that bilateral swinging is normally guided by central changes in the referent configuration of the two arms that function as a single unit. As a consequence, both arms cooperate in recovery from perturbation of motion applied to one arm. Results also suggest that stroke-related brain damage alters the symmetry of bilateral interaction, resulting in deficits of inter-manual cooperative action. The involvement of the non-paretic arm could be beneficial for the recovery of swinging of both arms and may also facilitate movements of the paretic arm in certain tasks.