Performance of the ‘Unaffected’ Upper Extremity of Elderly Stroke Patients

Abstract

Many factors (frequency of use of the unaffected hand, sensorimotor interaction tasks, severity of the deficits in corticifugal projections, and deficits in postural stabilization) could interact to provide the clinical picture obtained in the present study.

Does motor lateralization have implications for stroke rehabilitation?

“…In fact, Healey et al described similar distinctions in dominant and nondominant arm use for a wide range of tasks across a large number of subjects [2]. The dynamic dominance model has recently been supported in studies of righthanded stroke patients that reveal deficits in the ipsilesional arm, the quality of which tend to vary with the side of the lesion [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17]. The ipsilesional arm of these patients tends to show deficits in trajectory control following lefthemisphere damage and positional control following righthemisphere damage.…”

“…Most interesting is the prediction that damage to either the dominant or nondominant hemisphere should produce deficits in control of the ipsilesional limb. Studies in animals [18][19][20] as well as in patients with unilateral brain damage [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] have provided strong support to this idea. Haaland et al have used perceptual motor tasks, which require rapid reciprocal tapping between two targets that vary in size and/or target distance, to examine movement deficits in the ipsilesional arm of stroke patients [5][6][7][8][9][118][119].…”

“…In fact, both animal studies [18][19][20] and human studies [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] have revealed that unilateral brain damage can produce significant ipsilesional motor deficits. Studies in chronic stroke patients have reported performance deficiencies on the Purdue Pegboard Test [21], the JebsenTaylor Hand Function Test [22], as well as other tests that simulate activities of daily living (ADL) [4,10,[13][14]. In addition, significant ipsilesional deficits in movement coordination and accuracy have been revealed with the use of motion capture systems [3,[10][11][12]15,17].…”

“…In addition, significant ipsilesional deficits in movement coordination and accuracy have been revealed with the use of motion capture systems [3,[10][11][12]15,17]. Some studies that measured functional deficits have shown symmetric patterns that do not vary with lesion side [4,14,17]. However, Wetter et al have recently shown that while deficiencies in functional performance tests can be similar for patients with right-and left-hemisphere damage, this pattern can result from differences in the underlying dysfunction [14].…”

Parameters Representing Muscle Tone, Elasticity and Stiffness of Biceps Brachii in Healthy Older Males: Symmetry and Within-Session Reliability Using the MyotonPRO

“…Between-side symmetry may be a useful way of assessing abnormality as result of injury. However, in stroke patients, for example, evidence suggests the presence of reduced strength and sensorimotor function of the non-hemiplegic contralateral limb compared to healthy controls [32]. Development of disuse phenomena, decreased contralateral stabilisation of the affected side [33] and ipsilateral motor damage [34] could result in a decrease in resting muscle tone of the contralateral side.…”