Effects of visual terminal feedback on hand dexterity in relation to visuospatial ability in patients with subacute stroke: A preliminary study

Abstract

Background Hand dexterity impairments in patients with stroke reduce activities of daily living (ADL) and quality of life. Task-specific training with feedback (FB) for stroke rehabilitation have yielded inconsistent results on enhancing motor learning among stroke survivors. Furthermore, visuospatial ability is associated with motor learning, but this has not previously been reported in patients with subacute stroke. Therefore, we aimed to investigate whether visual terminal FB affects motor learning of hand dexterity, as well as the relationship among motor function, visuospatial ability, and motor learning, in patients with subacute stroke. Methods Seventeen patients (age: 66.1 ± 13.8 years) with subacute stroke who had mild upper limb motor impairment were included in this study. The experimental task was to adjust the force control task. The visuospatial task was the Rey–Osterrieth Complex Figure Test (ROCFT). The experimental protocol was conducted on 2 consecutive days, with day 1 consisting of a pre-test (PRE), practice, and short-term retention test (SRT), and day 2 consisting of a long-term retention test (LRT) and the ROCFT. The difference between the target grasping force and the measurement results (grasping error) was assessed as the dependent variable, as a measure of motor learning, using the Friedman test and post hoc test. Spearman’s rank correlation analysis was used to evaluate correlations of the grasping error in each test, motor function (by Fugl–Meyer assessment of the upper extremity and action research arm test), and copy, organization, and recall ROCFT scores. Results Grasping error significantly decreased in the SRT and LRT compared with the PRE values. Furthermore, no significant correlation was found between motor function and performance on each test, whereas significant moderate negative correlations were found between copy and recall scores and performance on LRT (ρ = -0.51 and − 0.53, respectively). Conclusion Our findings indicate that visual terminal FB improved hand dexterity in patients with subacute stroke who had mild upper-limb motor impairment. Visual ability was an important factor associated with motor learning. Future studies should use visual terminal FB and consider the establishment of training programs for visuospatial ability in stroke rehabilitation.