Article

An increasing number of studies have indicated that the ipsilesional
arm may be impaired after stroke. There is, however,
a lack of knowledge whether
ipsilesional deficits influence movement performance during purposeful daily tasks.
The aim of this study was to investigate whether, and to what
extent, movement impairments are present while performing an ipsilesional upper
extremity task during the first 3 months after stroke.
METHODS: Movement
kinematics describing movement time, smoothness, velocity, strategy, and pattern
were captured during a standardized drinking task in 40 persons with first-ever
stroke and 20 controls. Kinematics were measured early and at 3 months
poststroke, and sensorimotor impairment was assessed with Fugl-Meyer Assessment
in stroke. RESULTS: Half of the ipsilesional kinematics showed significant
deficits early after stroke compared to controls, and the stroke severity had a
significant impact on the kinematics. Movements of the ipsilesional arm were
slower, less smooth, demonstrated prolonged relative time in deceleration, and
increased arm abduction during drinking. Kinematics improved over time and
reached a level comparable with controls at 3 months, except for angular velocity
of the elbow and deceleration time in reaching for those with more severe motor
impairment. CONCLUSIONS: This study demonstrates that movements of the
ipsilesional arm, during a purposeful daily task, are impaired after stroke.
These deficits are more prominent early after stroke and when the motor
impairment is more severe. In clinical studies and praxis, the use of
less-affected arm as a reference may underestimate the level of impairment and
extent of recovery.

Langue : ANGLAIS