The beneficial effects of a functional task target on reaching and postural balance in patients with right cerebral vascular accidents.

This study evaluated the effect of context on the reaching performance of the unaffected arm and postural control while standing in patients with right cerebral vascular accidents (RCVA) and in healthy adults. Fifteen subjects with RCVA and sixteen healthy subjects performed tasks with the right hand under two conditions while standing. One condition involved moving coins forward on a table as far as possible (concrete task) and the other reaching forward without a target (abstract task). Forward reaching distance, forward displacement and lateral shift of center of pressure (CoP), and weight distribution were the dependent variables. The RCVA and control groups achieved significantly greater reaching distances in the concrete task than in the abstract one. The RCVA group showed significantly less lateral shift of the CoP and placed more weight on the affected leg in the concrete than the abstract task, whereas the control group made a greater lateral shift in the concrete task and had a similar mean ratio of weight distribution during both tasks. The results demonstrate that a functional application of task targets may favorably modulate both reaching and posture performance and exert various positive affects on postural control. Such applications may have a place in the therapeutic recovery efforts for patients afflicted with stroke.