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Background:  Better upper limb recovery after stroke could be achieved through tailoring rehabilitation interventions directly at movement deficits.   Aim:  To  identify potential; targets for therapy by  synthesiz ing  findings of differences in kinematics and muscle activity between stroke survivors and healthy adults performing reach-to-target tasks.   Methods:  A systematic review with identification of studies, data extraction, and potential risk of bias was completed independently by two reviewers. Online databases were searched from their inception to November 2017 to find studies of reach-to-target in  people-with-stroke  and healthy adults.  Potential  risk-of-bias was assessed using the Down's and Black Tool. Synthesis  was undertaken via : (a) meta-analysis of kinematic characteristics utilizing the standardized mean difference (SMD) [95% confidence intervals]; and (b), narrative synthesis of muscle activation.   Results:  Forty-six studies met the review criteria but 14 had insufficient data for extraction. Consequently, 32 studies were included  in the meta-analysis . Potential risk-of-bias was low for one study, unclear for 30, and high for one. Reach-to-target was investigated with 618  people-with-stroke  and 429 healthy adults.  The meta-analysis  found, in all areas of workspace, that  people-with-stroke had : greater movement times (seconds) e.g., SMD 2.57 [0.89, 4.25]; lower peak velocity (millimeters/second) e.g., SMD −1.76 [−2.29, −1.24]; greater trunk displacement (millimeters) e.g. SMD 1.42 [0.90, 1.93];  a more curved reach-path-ratio  e.g., SMD 0.77 [0.32, 1.22] and reduced movement smoothness e.g., SMD 0.92 [0.32, 1.52]. In  the  ipsilateral and contralateral workspace,  people-with-stroke exhibited : larger errors in  target  accuracy e.g., SMD 0.70 [0.39, 1.01]. In contralateral workspace, stroke survivors had: reduced elbow extension and shoulder flexion (degrees) e.g., elbow extension SMD −1.10 [−1.62, −0.58] and reduced shoulder flexion SMD −1.91 [−1.96, −0.42]. Narrative synthesis of muscle activation found that  people-with-stroke, compared with healthy adults , exhibited: delayed muscle activation; reduced coherence between muscle pairs; and use of a greater percentage of muscle power.   Conclusions:  This first-ever meta-analysis of the kinematic differences between people with stroke and healthy adults performing reach-to-target found statistically significant differences for 21 of the 26 comparisons.  The differences identified and values provided are potential foci for tailored rehabilitation interventions to improve upper limb recovery after stroke .

Kinematic Components of the Reach-to-Target Movement After Stroke for Focused Rehabilitation Interventions: Systematic Review and Meta-Analysis