Article

OBJECTIVE: To investigate the time-related changes in motor performance of the
ipsilesional upper limb in subacute poststroke patients by using clinical and
kinematic assessments. DESIGN: Observational, longitudinal, prospective,
monocentric study. SETTING: Physical medicine and rehabilitation department.
PARTICIPANTS: Stroke patients (n=19; mean age, 62.9y) were included less than 30
days after a first unilateral ischemic/hemorrhagic stroke. The control group was
composed of age-matched, healthy volunteers (n=9; mean age, 63.1y).
INTERVENTIONS: Clinical and kinematic assessments were conducted once a week
during 6 weeks and 3 months after inclusion. Clinical measures consisted of
Fugl-Meyer Assessment, Box and Block Test (BBT), Nine-Hole Peg Test (9HPT), and
Barthel Index. We used a 3-dimensional motion recording system during a
reach-to-grasp task to analyze movement smoothness, movement time, and peak
velocity of the hand. Healthy controls performed both clinical (BBT and 9HPT) and
kinematic evaluation within a single session. MAIN OUTCOME MEASURES: BBT and
9HPT. RESULTS: Recovery of ipsilesional upper arm capacities increased over time
and leveled off after a 6-week period of rehabilitation, corresponding to 9 weeks
poststroke. At study discharge, patients demonstrated similar ipsilesional
clinical scores to controls but exhibited less smooth reaching movements. We
found no effect of the hemispheric side of the lesion on ipsilesional motor
deficits. CONCLUSIONS: Our findings provide evidence that ipsilesional motor
capacities remain impaired at least 3 months after stroke, even if clinical tests
fail to detect the impairment. Focusing on this lasting ipsilesional impairment
through a more detailed kinematic analysis could be of interest to understand the
specific neural network underlying ipsilesional upper-limb impairment.
CI - Copyright (c) 2013 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS