FUNCTIONAL DEFICITS IN CHRONIC STROKE DEPEND ON EXTENT OF CONTRALESIONAL IMPAIRMENT AND ON THE SIDE OF BRAIN DAMAGE
Open Access
Author:
Maenza, Candice Marie
Graduate Program:
Kinesiology
Degree:
Master of Science
Document Type:
Master Thesis
Date of Defense:
July 10, 2018
Committee Members:
Robert L Sainburg, Thesis Advisor/Co-Advisor Mark Latash, Committee Member Chaleece Wyatt Sandberg, Committee Member
Keywords:
stroke motor deficits ipsilesional
Abstract:
Previous research has detailed the hemisphere dependence and specific behavioral nature of non-paretic arm motor deficits in patients with unilateral stroke. We now examine whether these deficits depend on hemisphere of damage and severity of contralesional paresis by quantifying the effect of unilateral stroke on clinical tests of motor function. We recruited 48 left hemisphere damaged (LHD) participants, 62 right hemisphere damaged (RHD) participants, and 54 age matched control participants. Measures of motor function included: 1) Jebsen-Taylor Hand Function Test (JTHFT), 2) Grooved Pegboard Test, and 3) Grip strength. We measured the extent of contralesional impairment with the upper extremity component of the Fugl-Meyer (UEFM) assessment of motor impairment. Non-paretic arm motor deficits depended strongly on severity of contralesional arm impairment on all measures, but hemisphere specific deficits were only evident on some measures. LHD participants with severe paresis (UEFM < 28) took, on average, 112% longer to complete the JTHFT than control participants using the left non-dominant arm (p < 0.0001), while the severe RHD group took, on average, 61% longer than control participants using the right arm (p < 0.0001). Thus, stroke survivors with the most severe paretic arm impairment, who must rely on their ipsilesional arm for daily activities, have the greatest motor deficit in the non-paretic arm. We recommend remediation of this arm to improve functional independence in this cohort of stroke patients.
