Article

Poststroke impairments of the ipsilesional arm are often discussed,
but rarely receive focused rehabilitation. Ipsilesional deficits may affect daily
function and although many studies have investigated them in chronic stroke, few
characterizations have been made in the subacute phase. Furthermore, most studies
have quantified ipsilesional deficits using clinical measures that can fail to
detect subtle, but important deficits in motor function. OBJECTIVE: We aimed to
quantify reaching deficits of the contra- and ipsilesional limbs in the subacute
phase poststroke. METHODS: A total of 227 subjects with first-time, unilateral
stroke completed a unilateral assessment of motor function (visually guided
reaching) using a KINARM robot. Subjects completed the task with both the ipsi-
and contralesional arms. Subjects were assessed on a variety of traditional
clinical measures (Functional Independence Measure, Chedoke-McMaster Stroke
Assessment, Purdue Pegboard, Behavioral Inattention Test) to compare with robotic
measures of motor function. RESULTS: Ipsilesional deficits were common and
occurred in 37% (n = 84) of subjects. Impairments of the ipsilesional and
contralesional arm were weakly to moderately correlated on robotic measures.
Magnitude of impairment of the contralesional arm was similar for subjects with
and without ipsilesional deficits. Furthermore, we found that a higher percentage
of subjects with right-hemisphere stroke had ipsilesional deficits and more
subjects with left-hemisphere subcortical strokes did not have ipsilesional
deficits. CONCLUSIONS: Magnitude of contralesional impairment and lesion location
may be poor predictors of individuals with ipsilesional impairments after stroke.
Careful characterization of ipsilesional deficits could identify individuals who
may benefit from rehabilitation of the less affected arm.

Langue : ANGLAIS