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Research Article  |   July 2002
Effect of Instructions on Functional Reach in Persons With and Without Cerebrovascular Accident
Author Affiliations
  • Susan E. Fasoli, ScD, OTR/L, is Post-Doctoral Fellow, Department of Mechanical Engineering, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Room 3-147, Cambridge, Massachusetts 02139-4307; sfasoli@mit.edu
  • Catherine A. Trombly, ScD, OTR/L, FAOTA, is Professor Emerita, Department of Occupational Therapy, Boston University, Boston, Massachusetts
  • Linda Tickle-Degnen, ScD, OTR/L, is Associate Professor, Department of Occupational Therapy, Boston University, Boston, Massachusetts
  • Mieke H. Verfaellie, PhD, is Associate Professor, Department of Psychiatry and Psychology, Boston University, Boston, Massachusetts
Article Information
Neurologic Conditions / Stroke / Kinematic and Kinetic Measures
Research Article   |   July 2002
Effect of Instructions on Functional Reach in Persons With and Without Cerebrovascular Accident
American Journal of Occupational Therapy, July/August 2002, Vol. 56, 380-390. doi:10.5014/ajot.56.4.380
American Journal of Occupational Therapy, July/August 2002, Vol. 56, 380-390. doi:10.5014/ajot.56.4.380
Abstract

OBJECTIVE. Verbal instructions comprise an important element of clinical practice, however, their effectiveness in promoting movement organization in persons with cerebrovascular accident (CVA) has not been well investigated.

METHOD. A counterbalanced, repeated-measures design was used to examine the effects of externally focused (task-related) versus internally focused (movement-related) instructions on movement kinematics during three functional reaching tasks. Participants included 16 persons with stroke who were able to perform the tasks with their affected arm and 17 age-matched adults without neurological impairments.

RESULTS. Significantly shorter movement time and greater peak velocity were evident when reaching under the external-focus condition of all tasks than for the internal-focus condition.

CONCLUSION. One clinical implication is that internally focused instructions can contribute to slower and less forceful reach in adults with and without CVA. This research reinforces the need for therapists to consider their use of instruction during the evaluation and treatment of movement disorders.