Symmetry and synchrony of bimanual movements are not predicated on interlimb control coupling.

Previous studies suggest that bimanual coordination recruits neural mechanisms that explicitly couple control of the arms, resulting in symmetric kinematics. However, the higher symmetry for actions that require congruous joint motions compared with noncongruous joint motions calls into question the concept of control coupling as a general policy. An alternative view proposes that codependence might emerge from an optimal feedback controller that minimizes control effort and costs in task performance. Support for this view comes from studies comparing conditions in which both hands move a shared or independent virtual objects. Because these studies have mainly focused on congruous bimanual movements, it remains unclear if kinematic symmetry emerges from such control policies. We now examine movements with congruous or noncongruous joint motions (inertially symmetric or asymmetric, respectively) under shared or independent cursors conditions. We reasoned that if a control policy minimizes kinematic differences between limbs, spatiotemporal symmetry should remain relatively unaffected by inertial asymmetries. As shared tasks reportedly elicit greater interlimb codependence, these conditions should elicit higher bilateral covariance regardless of inertial asymmetries. Our results indicate a robust spatiotemporal symmetry only under inertially symmetric conditions, regardless of cursor condition. We simulated bimanual reaching using an optimal feedback controller with and without explicit costs of kinematic asymmetry, finding that only the latter mirrored our empirical data. Our findings support the hypothesis that bimanual control policies do not include kinematic asymmetry as a cost when it is not demanded by task constraints suggesting that kinematic symmetry depends critically on mechanical movement conditions.NEW & NOTEWORTHY Previously, the control coupling hypothesis and task-dependent control hypothesis have been shown to be robust in the bimanually symmetrical movement, but whether the same policy remains robust in the bimanually asymmetrical movement remains unclear. Here, with evidence from empirical and simulation data, we show that a spatiotemporal symmetry between the arms is not predicated on control coupling, but instead it is predicated on the symmetry of mechanical conditions (e.g. limb inertia) between the arms.

Bilateral arm movements are coordinated via task-dependent negotiations between independent and codependent control, but not by a "coupling" control policy.

Prior research has shown that coordination of bilateral arm movements might be attributed to either control policies that minimize performance and control costs regardless of bilateral symmetry or by control coupling, which activates bilaterally homologous muscles as a single unit to achieve symmetric performance. We hypothesize that independent bimanual control (movements of one arm are performed without influence on the other) and codependent bimanual control (two arms are constrained to move together with high spatiotemporal symmetry) are two extremes on a coordination spectrum that can be negotiated to meet infinite variations in task demands. To better understand and distinguish between these views, we designed a task where minimization of either control costs or asymmetry would yield different patterns of coordination. Participants made bilateral reaches with a shared visual cursor to a midline target. We then covertly varied the gain contribution of either hand to the shared cursor's horizontal position. Across two experiments, we show that bilateral coordination retains high task-dependent sensitivity to subtle visual feedback gain asymmetries applied to the shared cursor. Specifically, we found a change from strong spatial covariation between hands during equal gains to more independent control during asymmetric gains, which occurred rapidly and with high specificity to the dimension of gain manipulation. Furthermore, the extent of spatial covariation was graded to the magnitude of perpendicular gain asymmetry between hands. These findings suggest coordination of bilateral arm movements flexibly maneuvers along a continuous coordination spectrum in a task-dependent manner that cannot be explained by bilateral control coupling.NEW & NOTEWORTHY Minimization of performance and control costs and efferent coupling between bilaterally homologous muscle groups have been separately hypothesized to describe patterns of bimanual coordination. Here, we address whether the mechanisms mediating independent and codependent control between limbs can be weighted for successful task performance. Using bilaterally asymmetric visuomotor gain perturbations, we show bimanual coordination can be characterized as a negotiation along a spectrum between extremes of independent and codependent control, but not efferent control coupling.

Reaction time asymmetries provide insight into mechanisms underlying dominant and non-dominant hand selection.

Handedness is often thought of as a hand "preference" for specific tasks or components of bimanual tasks. Nevertheless, hand selection decisions depend on many factors beyond hand dominance. While these decisions are likely influenced by which hand might show performance advantages for the particular task and conditions, there also appears to be a bias toward the dominant hand, regardless of performance advantage. This study examined the impact of hand selection decisions and workspace location on reaction time and movement quality. Twenty-six neurologically intact participants performed targeted reaching across the horizontal workspace in a 2D virtual reality environment, and we compared reaction time across two groups: those selecting which hand to use on a trial-by-trial basis (termed the choice group) and those performing the task with a preassigned hand (the no-choice group). Along with reaction time, we also compared reach performance for each group across two ipsilateral workspaces: medial and lateral. We observed a significant difference in reaction time between the hands in the choice group, regardless of workspace. In contrast, both hands showed shorter but similar reaction times and differences between the lateral and medial workspaces in the no-choice group. We conclude that the shorter reaction times of the dominant hand under choice conditions may be due to dominant hand bias in the selection process that is not dependent upon interlimb performance differences.

Left hemisphere damage produces deficits in predictive control of bilateral coordination.

Previous research has demonstrated hemisphere-specific motor deficits in ipsilesional and contralesional unimanual movements in patients with hemiparetic stroke due to MCA infarct. Due to the importance of bilateral motor actions on activities of daily living, we now examine how bilateral coordination may be differentially affected by right or left hemisphere stroke. To avoid the caveat of simply adding unimanual deficits in assessing bimanual coordination, we designed a unique task that requires spatiotemporal coordination features that do not exist in unimanual movements. Participants with unilateral left (LHD) or right hemisphere damage (RHD) and age-matched controls moved a virtual rectangle (bar) from a midline start position to a midline target. Movement along the long axis of the bar was redundant to the task, such that the bar remained in the center of and parallel to an imaginary line connecting each hand. Thus, to maintain midline position of the bar, movements of one hand closer to or further away from the bar midline required simultaneous, but oppositely directed displacements with the other hand. Our findings indicate that left (LHD), but not right (RHD) hemisphere-damaged patients showed poor interlimb coordination, reflected by significantly lower correlations between displacements of each hand along the bar axis. These left hemisphere-specific deficits were only apparent prior to peak velocity, likely reflecting predictive control of interlimb coordination. In contrast, the RHD group bilateral coordination was not significantly different than that of the control group. We conclude that predictive mechanisms that govern bilateral coordination are dependent on left hemisphere mechanisms. These findings indicate that assessment and training in cooperative bimanual tasks should be considered as part of an intervention framework for post-stroke physical rehabilitation.

Preferred directions of arm movements are independent of visual perception of spatial directions.

Directional preferences have previously been demonstrated during horizontal arm movements. These preferences were characterized by a tendency to exploit interaction torques for movement production at the shoulder or elbow, indicating that the preferred directions depend on biomechanical, and not on visual perception-based factors. We directly tested this hypothesis by systematically dissociating visual information from arm biomechanics. Sixteen subjects performed a free-stroke drawing task that required performance of fast strokes from the circle center toward the perimeter, while selecting stroke directions in a random order. Hand position was represented by a cursor displayed in the movement plane. The free-stroke drawing was performed twice, before and after visuomotor adaptation to a 30° clockwise rotation of the perceived hand path. The adaptation was achieved during practicing pointing movements to eight center-out targets. Directional preferences during performance of the free-stroke drawing task were revealed in ten out of the sixteen subjects. The orientation and strength of these preferences were largely the same in both conditions, showing no significant effect of the visuomotor adaptation. In both conditions, the major preferred directions were characterized by higher contribution of interaction torque to net torque at the shoulder as well as by relatively low inertial resistance and the sum of squared shoulder and elbow muscle torques. These results support the hypothesis that directional preferences are largely determined by biomechanical factors. However, this biomechanical effect can decrease or even disappear in some subjects when movements are performed in special conditions, such as the virtual environment used here.

Contralesional motor deficits after unilateral stroke reflect hemisphere-specific control mechanisms.

We have proposed a model of motor lateralization, in which the left and right hemispheres are specialized for different aspects of motor control: the left hemisphere for predicting and accounting for limb dynamics and the right hemisphere for stabilizing limb position through impedance control mechanisms. Our previous studies, demonstrating different motor deficits in the ipsilesional arm of stroke patients with left or right hemisphere damage, provided a critical test of our model. However, motor deficits after stroke are most prominent on the contralesional side. Post-stroke rehabilitation has also, naturally, focused on improving contralesional arm impairment and function. Understanding whether contralesional motor deficits differ depending on the hemisphere of damage is, therefore, of vital importance for assessing the impact of brain damage on function and also for designing rehabilitation interventions specific to laterality of damage. We, therefore, asked whether motor deficits in the contralesional arm of unilateral stroke patients reflect hemisphere-dependent control mechanisms. Because our model of lateralization predicts that contralesional deficits will differ depending on the hemisphere of damage, this study also served as an essential assessment of our model. Stroke patients with mild to moderate hemiparesis in either the left or right arm because of contralateral stroke and healthy control subjects performed targeted multi-joint reaching movements in different directions. As predicted, our results indicated a double dissociation; although left hemisphere damage was associated with greater errors in trajectory curvature and movement direction, errors in movement extent were greatest after right hemisphere damage. Thus, our results provide the first demonstration of hemisphere specific motor control deficits in the contralesional arm of stroke patients. Our results also suggest that it is critical to consider the differential deficits induced by right or left hemisphere lesions to enhance post-stroke rehabilitation interventions.

Effects of Short-Term Novice Archery Training on Reaching Movement Performance and Interlimb Asymmetries.

Previous studies showed numerous evidence for the interlimb asymmetries in motor performance during arm reaching movements. Furthermore, these interlimb asymmetries have been shown to associate with spatial patterns of hand selection behavior. Importantly, these interlimb asymmetries can be modified systematically by occlusion of visual feedback, or a long-term sports training. In this study, we asked about the effects of a short-term training on interlimb asymmetries. Eighteen healthy young participants underwent a 12-week novice traditional archery training (TAT). Their unimanual dominant and nondominant arm reaching movement performance was assessed before and after TAT. We found that movement accuracy, movement precision, and movement efficiency in the experimental group have all improved significantly as a result of TAT. These improvements were comparable across both arms, thus the interlimb differences in movement performance were not affected by the short-term TAT and remained similar. These results suggest that while short-term training may contribute positively to reaching performance, it is unlikely to have a significant impact on the differences observed between the dominant and nondominant arms. This unique characteristics of dominant and nondominant arm should be taken into consideration when developing targeted sports and rehabilitation programs for athletes or individuals with acute or chronic motor deficits.

Hemispheric differences in the control of limb dynamics: a link between arm performance asymmetries and arm selection patterns.

Human handedness has been described and measured from two perspectives: handedness inventories rate hand preferences, whereas other tests examine motor performance asymmetries. These two measurement approaches reflect a major controversy in a literature that defines handedness as either a preference or an asymmetry in sensorimotor processing. Over the past decade, our laboratory has developed a model of handedness based on lateralization of neural processes. This model attributes distinct control processes to each hemisphere, which in turn lead to observable interlimb sensorimotor performance asymmetries. We now hypothesize that arm preference, or choice, may depend on the interaction between sensorimotor performance asymmetries and the given task. The purpose of this study is to examine whether arm selection is linked to interlimb performance asymmetries during reaching. Right-handed subjects made choice and nonchoice reaches to each of eight targets (d = 3.5 cm) arranged radially (r = 13 cm) around a midline starting position. We displaced each cursor (one associated with each hand) 30 cm to the midline start circle to ensure that there were no hemispace-related geometric, mechanical, or perceptual biases to use either arm for the two midline targets. The three targets on each side of the midline received mostly reaches from the ipsilateral arm, a tendency previously described as a "hemispace bias." However, the midline targets, which were equidistant from each hand, received more dominant arm reaches. Dominant arm hand paths to these targets were straighter and more accurately directed. Inverse dynamics analyses revealed a more proficient dominant arm strategy that exploited intersegmental dynamics to a greater extent than did the nondominant arm. These findings suggest that sensorimotor asymmetries in dynamic coordination might explain limb choices. We discuss the implications of these results for theories of action selection, models of handedness, and models of neural lateralization.

Dynamic dominance varies with handedness: reduced interlimb asymmetries in left-handers.

Our previous studies of interlimb asymmetries during reaching movements have given rise to the dynamic-dominance hypothesis of motor lateralization. This hypothesis proposes that dominant arm control has become optimized for efficient intersegmental coordination, which is often associated with straight and smooth hand-paths, while non-dominant arm control has become optimized for controlling steady-state posture, which has been associated with greater final position accuracy when movements are mechanically perturbed, and often during movements made in the absence of visual feedback. The basis for this model of motor lateralization was derived from studies conducted in right-handed subjects. We now ask whether left-handers show similar proficiencies in coordinating reaching movements. We recruited right- and left-handers (20 per group) to perform reaching movements to three targets, in which intersegmental coordination requirements varied systematically. Our results showed that the dominant arm of both left- and right-handers were well coordinated, as reflected by fairly straight hand-paths and low errors in initial direction. Consistent with our previous studies, the non-dominant arm of right-handers showed substantially greater curvature and large errors in initial direction, most notably to targets that elicited higher intersegmental interactions. While the right, non-dominant, hand-paths of left-handers were slightly more curved than those of the dominant arm, they were also substantially more accurate and better coordinated than the non-dominant arm of right-handers. Our results indicate a similar pattern, but reduced lateralization for intersegmental coordination in left-handers. These findings suggest that left-handers develop more coordinated control of their non-dominant arms than right-handers, possibly due to environmental pressure for right-handed manipulations.

Fire blight resistance of pear genotypes from different European countries.

Several old cultivars, and breeding clones of European pear Pyrus communis L. originating from Belgium, England, Sweden, and Switzerland were evaluated for their resistance/susceptibility to fire blight. Studies were carried out during three consecutive years 2007-2009 in the greenhouse of Warsaw University of Life Sciences, Poland. Strain 691 of Erwinia amylovora was used for artificial infection of plants. Genotypes included in this study considerably varied in their resistance to fire blight. The most resistant was the old English cultivar 'Hessle'. The other two genotypes, i.e., 'Gränna Rödpäron' originating from Sweden, and Pyrus communis FG 1606 from Switzerland were included in a group of low susceptible ones. The most susceptible were Cra Py H 18, Cra Py V 22 and Cra Py W 14 from Belgium.

[Molecular aspects of allergy to plant products. Part III. Panallergens and breeding of hypoallergenic cultivars]. / Molekularne aspekty alergii na produkty pochodzenia roslinnego. Cz. III. Panalergeny oraz hodowla odmian hypoalergogennych.

In addition to major allergens, also minor allergens, i.e. panallergens have been shown to be responsible for many IgE cross-reactions even between unrelated pollen and plant food allergen sources. It can be explained also by cross-allergenicity underlying the T cell response to conserved regions of panallergens. In this article, we focus on known panallergens which presently comprise a few protein families, including non-specific lipid transfer proteins (nsLTP) (PR-14), thaumatin like proteins (TLP) (PR-5), profilins, and polcalcins. Food allergy has an impact on the quality of life of an allergic patient. The way of developing novel plant cultivars with decreased allergenicity and possibility of down-regulating the expression of an allergen by genetic modification are discussed.

[Molecular aspects of allergy to plant products. Part II. Pathogenesis-related proteins (PRs), apple allergenicity governed by Mal d 1 gene]. / Molekularne aspekty alergii na produkty pochodzenia roslinnego. Cz. II. Bialka zwiazane z patogeneza (PR), alergogennosc jablek warunkowana genem Mal d 1.

Of the plant allergens listed in the Official Allergen Database of the International Union of Immunological Societies, approximately 25% belong to the group of pathogenesis-related proteins (PRs). They have been classified into 17 PR families based on similarities in their amino acid sequence, enzymatic activities, or other functional properties. Plant-derived allergens have been identified with sequence similarities to PR families 2, 3, 4, 5, 8, 10, and 14. The main birch allergen in northern Europe is a class 10 (PR-10) protein from the European white birch (Betula pendula) termed Bet v 1. Pollen of other Fagales species contains PR-10 homologues that share epitopes with Bet v 1, as do several fruits, nuts and vegetables. Among the plant food fruits of the Rosaceae family are the most frequently responsible for allergenic reactions. It is documented, that approximately 2% of European population is allergic to apples. The article presents molecular characterization of PR-10 proteins with regard to their structure and function as well as apple Mal d 1 gene-determined allergenicity.

[Molecular aspects of allergy to plant products. Part I. Class I and II allergens and crossreactivity of IgE antibodies]. / Molekularne aspekty alergii na produkty pochodzenia roslinnego. Czesc I. Alergeny klasy I i II oraz mechanizm reaktywnosci krzyzowej przeciwcial IgE.

Food allergies are adverse immunologic reactions that might be due to IgE--or none IgE-mediated immune mechanisms or mixed. One of the more common and typically most mild forms of IgE- mediated food allergy is the so-called oral allergy syndrome (OAS), although systemic symptoms after ingesting a particular fruit or vegetable can occur. Pollen food syndrome is the most common food allergy in adolescents and adults. It develops as a consequence of shared epitopes in the primary and tertiary structures of pollen and food allergens. The authors describe class I and class II allergens, as well as molecularly determined IgE-crossreactivity phenomenon. Also the problem of symptom-free consumed pollen-related food allergens, which might cause T cell-mediated late-phase skin reactions in patients with pollen allergy and atopic dermatitis, is taken up.

Aging reduces asymmetries in interlimb transfer of visuomotor adaptation.

Hemispheric asymmetry reduction in older adults (HAROLD) has been reported in previous imaging studies that employed not only cognitive, but also motor tasks. However, whether age-related reductions in asymmetry of hemispheric activations affect the symmetry of motor behavior in older adults remains largely untested. We now examine the effect of aging on lateralization of motor adaptation and transfer by investigating adaptation to novel visuomotor transformations in both old and young age groups. We have previously reported substantial asymmetries in interlimb transfer of learning these transformations in young adults, and attributed these asymmetries in transfer to hemispheric lateralization for motor control, as detailed by our dynamic dominance hypothesis. Based on the HAROLD model, we reasoned that older adults should recruit more symmetrical hemispheric activity, and thus show more symmetrical transfer of adaptation across the arms. Half of the subjects in each age group first adapted to a rotated visual display with the left arm, then with the right arm; and the other half in the reversed order. Naïve performance with one arm and the same-arm performance following opposite arm adaptation were compared to determine the extent of transfer in each age group. Our results showed that interlimb transfer of initial direction information only occurred from the nondominant to dominant arm in young adults, whereas it occurred in both directions in older adults. Our findings clearly indicate substantially reduced asymmetry in visuomotor adaptation in older adults, and suggest that this reduced motor asymmetry might be related to diminished hemispheric lateralization for motor control.

Effects of Fencing Training on Motor Performance and Asymmetry Vary With Handedness.

Previous studies showed that motor asymmetries are reduced in left-handers and after a long-term fencing training in right-handers. Interestingly, left-handed athletes are substantially over-represented in elite fencing. These findings have been speculatively explained by imbalance in experience of fighting opposite handedness opponents resulted from skewed distribution of handedness, i.e. lefties encounter more righties than righties encounter lefties. Whereas these assumptions could be accurate, the underlying mechanisms remain ambiguous. In this study, we investigated effects of fencing training on motor performance and asymmetry with respect to handedness. We compared fencing performance of left- and right-handed fencers in both training and combat conditions. In the combat condition, left-handers won seven out of twelve matches consisted of twelve bouts each. They also showed a significantly longer hit detection time, a measure indicating better quality of fencing attack. In the training condition, left-handed fencers completed fencing board tests significantly faster than right-handers. These findings provide additional factor of superior motor performance to be considered when interpreting over-representation of lefties in elite fencing. Furthermore, our left-handers were less lateralized, which could explain that superior motor performance. This idea is consistent with previous findings of reduced asymmetry in right-handed fencers when comparing to non-athletes.

Reduction of frontal plane knee load caused by lateral trunk lean depends on step width.

The internal knee abduction moment (KAM) in osteoarthritis is reduced by increased lateral trunk lean (TL). Mechanistically, this occurs as the Centre of Mass (COM) moves further over the stance leg. Since the size of the base of support constrains the COM, an associated increase in step width (SW) would be expected to maintain stability. This study tested the effects of TL on SW and KAM in healthy participants (n = 21) who performed normal and 6° TL walks. The latter was controlled via audio-visual biofeedback. We found two distinct gait strategies in TL walk: widening the step width substantially (>50%) to permit an increase in the COM displacement (WSW, n = 13), or maintaining a baseline SW and minimally displacing the COM by moving the hip/pelvic complex in the opposite direction (NSW, n = 8). WSW doubled SW (11.3 ±â€¯2.4 v. 24.7 ±â€¯5.5 cm, p < .0001), NSW did not change SW (12.2 ±â€¯2.8 v. 13.7 ±â€¯4.7 cm, p > .05). These two distinct gait strategies resulted in unique patterns of KAM reduction across the stance phase. NSW reduced KAM impulse significantly in the initial half (0.08 ±â€¯0.02 v. 0.06 ±â€¯0.02, p = .04) but not in the later stance phase (0.07 ±â€¯0.02 v. 0.07 ±â€¯0.04, p > .05). WSW reduced KAM significantly in both initial (0.11 ±â€¯0.03 v. 0.08 ±â€¯0.04, p < .001) and later stance phase (0.09 ±â€¯0.02 v. 0.06 ±â€¯0.03, p < .001). KAM peak results followed the pattern of impulse. This study has revealed two distinct mechanisms for increasing lateral trunk lean which can be used to explain discrepancies in past research and in the future could be used to individualise gait re-training strategies.

Outer annulus tears have less effect than endplate fracture on stress distributions inside intervertebral discs: relevance to disc degeneration.

BACKGROUND: Annulus tears and endplate fracture are common lesions in human intervertebral discs. Both cause degenerative changes in animal models, but the time course appears to be different. The purpose of the present experiment is to compare the effects of outer annulus tears and endplate fracture on intradiscal stresses. We hypothesise that endplate fracture provides a greater stimulus for disc degeneration. METHODS: Seven cadaveric lumbar "motion segments" aged 49-70 years were compressed at 2 kN while the distribution of compressive stress was measured in each disc by pulling a 1.3 mm-diameter pressure transducer along its mid-sagittal diameter. Measurements were repeated after rim tears were simulated by 10 mm-deep scalpel cuts into the outer anterior annulus. The first cut was horizontal, 15 mm to the right of the disc midline, near the junction with the upper endplate. The second cut was vertical, 15 mm to the left of the disc midline, at mid-disc height. The third cut was horizontal, in the disc midline and at mid-disc height, so that the cut passed through the needle hole of the pressure transducer. Stress profiles were recorded in three postures and at two load levels, after each cut. Stress measurements were repeated a final time following compressive overload sufficient to fracture the endplate. FINDINGS: Outer annulus tears had negligible effect on compressive stress distributions in the annulus fibrosus more than 15 mm from the scalpel cut, and they caused nucleus pressure to fall by only 1% (SD 1.3%, NS). In contrast, endplate fracture reduced nucleus pressure by 37% (P=0.004) and increased maximum stress within the posterior annulus by 93% (P=0.033). INTERPRETATION: Outer annulus tears have less (immediate) effects on intradiscal compressive stresses than endplate fracture, supporting our hypothesis.

Motor asymmetry in elite fencers.

The authors previously reported that asymmetrical patterns of hand preference are updated and modified by present sensorimotor conditions. They examined whether participation in long-term training in the upper extremity sport fencing might modify arm selection and performance asymmetries. Eight fencers and eight nonfencers performed reaching movements under 3 experimental conditions: (a) nonchoice right, (b) nonchoice left, and (c) choice, either right or left arm as selected by subject. The nonchoice conditions allowed assessment of potential interlimb differences in movement performance, while the choice condition allowed assessment of the frequency and pattern of arm selection across subject groups. Our findings showed that the athlete group showed substantially greater symmetry in the performance and selection measures. These findings suggest that arm selection and performance asymmetries can be altered by intense long-term practice.

Contralesional Arm Preference Depends on Hemisphere of Damage and Target Location in Unilateral Stroke Patients.

Background Previous research has shown that during simulated activities of daily living, right-handed stroke patients use their contralesional arm more after left- than right-hemisphere stroke. These findings were attributed to a hand preference effect. However, these decisions about when to use the contralesional arm may be modulated by where in the work space the task is performed, a factor that could be used in physical rehabilitation to influence recovery by decreasing learned nonuse. Objective To examine how target location and side of stroke influences arm selection choices for simple reaching movements. Methods A total of 14 right-handed stroke patients (7 with left-hemisphere and 7 with right-hemisphere damage [RHD]), with similar degrees of hemiparesis (Fugl-Meyer motor score), and 16 right-handed controls participated in this experiment. In a pseudorandom fashion, 32 targets were presented throughout the reachable horizontal plane work space, and the participants were asked to select 1 hand to reach the target on each trial. Results The group with left-hemisphere damage chose their contralesional arm significantly more often than the group with RHD. Patients with RHD also chose their left (contralesional) arm significantly less often than the control group. However, these patterns of choice were most pronounced in the center of the workspace. Conclusion Both the side of hemisphere damage and work space location played a significant role in the choice of whether to use the contralesional arm for reaching. These findings have implications for structuring rehabilitation for unilateral stroke patients.