Abstract
Most stroke patients do not use their paretic limb sufficiently, even when they are able to do so, which can lead to secondary loss of function. Our aim is to evaluate whether target height has an impact on non-use during a PANU test. Methods: 22 stroke patients (>1 month) were asked to touch a target in 2 conditions: high target (80cm), low target (67cm). In each condition, the task was first performed spontaneously, then by minimizing the use of the trunk, so as to maximize the shoulder-elbow use. Elbow-shoulder-trunk use was recorded by motion capture, and the sensation of effort with a Borg scale. Results: To date, 17 patients have been included (8 women, 62±8 years old, 10 left hemiplegic). With the low target, most patients had a high PANU (14±19%): they compensated with the trunk spontaneously, but could decrease the compensation when asked. With the high target, the PANU decreased by 30%: patients compensated spontaneously, but could NOT decrease the compensation. Trunk anteflexion decreases the antigravity torque at the shoulder by an average of 12% and the sensation of effort by an average of 20%. These benefits are greater with the low target than with the high target. Discussion: The trunk anteflexion strategy is, at least in part, a successful adaptation to the constraints of the task (height of the target) and to the internal constraints (antigravity torque at the shoulder). Particular attention must be paid to the way the PANU test is performed to avoid misinterpretations and to be able to compare the results with those in the literature.