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Functional Deficits in the Less-Impaired Arm of Stroke Survivors Depend on Hemisphere of Damage and Extent of Paretic Arm Impairment
Neurorehabilitation and Neural Repair ( IF 4.2 ) Pub Date : 2019-09-20 , DOI: 10.1177/1545968319875951
Candice Maenza 1, 2 , David C Good 2 , Carolee J Winstein 3 , David A Wagstaff 1 , Robert L Sainburg 1, 2
Affiliation  

Background. Previous research has detailed the hemisphere dependence and specific kinematic deficits observed for the less-affected arm of patients with unilateral stroke. Objective. We now examine whether functional motor deficits in the less-affected arm, measured by standardized clinical measures of motor function, also depend on the hemisphere that was damaged and on the severity of contralesional impairment. Methods. We recruited 48 left-hemisphere-damaged (LHD) participants, 62 right-hemisphere-damaged participants, and 54 age-matched control participants. Measures of motor function included the following: (1) Jebsen-Taylor Hand Function Test (JHFT), (2) Grooved Pegboard Test (GPT), and (3) grip strength. We measured the extent of contralesional arm impairment with the upper-extremity component of the Fugl-Meyer (UEFM) assessment of motor impairment. Results. Ipsilesional limb functional performance deficits (JHFT) varied with both the damaged hemisphere and severity of contralesional arm impairment, with the most severe deficits expressed in LHD participants with severe contralesional impairment (UEFM). GPT and grip strength varied with severity of contralesional impairment but not with hemisphere. Conclusions. Stroke survivors with the most severe paretic arm impairment, who must rely on their ipsilesional arm for performing daily activities, have the greatest motor deficit in the less-affected arm. We recommend remediation of this arm to improve functional independence in this group of stroke patients.

中文翻译:

中风幸存者受损较轻手臂的功能缺陷取决于受损半球和麻痹手臂受损的程度

背景。先前的研究详细说明了单侧中风患者受影响较小的手臂所观察到的半球依赖性和特定的运动学缺陷。客观的。我们现在检查受影响较小的手臂的功能性运动缺陷,通过运动功能的标准化临床测量来衡量,是否也取决于受损的半球和对侧损伤的严重程度。方法。我们招募了 48 名左半球损伤 (LHD) 参与者、62 名右半球损伤参与者和 54 名年龄匹配的对照组参与者。运动功能的测量包括以下内容:(1) Jebsen-Taylor 手部功能测试 (JHFT),(2) 凹槽钉板测试 (GPT),以及 (3) 握力。我们使用 Fugl-Meyer (UEFM) 运动损伤评估的上肢组件测量了对侧手臂损伤的程度。结果。同侧肢体功能障碍 (JHFT) 因半球受损和对侧手臂损伤的严重程度而异,其中最严重的缺陷在患有严重对侧损伤 (UEFM) 的 LHD 参与者中表现出来。GPT 和握力随对侧损伤的严重程度而变化,但与半球无关。结论。具有最严重的麻痹性手臂损伤的中风幸存者必须依靠其同侧手臂进行日常活动,而受影响较小的手臂的运动障碍最大。我们建议修复该臂以改善这组卒中患者的功能独立性。同侧肢体功能障碍 (JHFT) 因半球受损和对侧手臂损伤的严重程度而异,其中最严重的缺陷在患有严重对侧损伤 (UEFM) 的 LHD 参与者中表现出来。GPT 和握力随对侧损伤的严重程度而异,但与半球无关。结论。具有最严重麻痹性手臂损伤的中风幸存者必须依靠其同侧手臂进行日常活动,而受影响较小的手臂的运动障碍最大。我们建议修复该臂以改善这组卒中患者的功能独立性。同侧肢体功能障碍 (JHFT) 因半球受损和对侧手臂损伤的严重程度而异,其中最严重的缺陷在患有严重对侧损伤 (UEFM) 的 LHD 参与者中表现出来。GPT 和握力随对侧损伤的严重程度而变化,但与半球无关。结论。具有最严重的麻痹性手臂损伤的中风幸存者必须依靠其同侧手臂进行日常活动,而受影响较小的手臂的运动障碍最大。我们建议修复该臂以改善这组卒中患者的功能独立性。在患有严重对侧损伤 (UEFM) 的 LHD 参与者中表现出最严重的缺陷。GPT 和握力随对侧损伤的严重程度而变化,但与半球无关。结论。具有最严重的麻痹性手臂损伤的中风幸存者必须依靠其同侧手臂进行日常活动,而受影响较小的手臂的运动障碍最大。我们建议修复该臂以改善这组卒中患者的功能独立性。在患有严重对侧损伤 (UEFM) 的 LHD 参与者中表现出最严重的缺陷。GPT 和握力随对侧损伤的严重程度而变化,但与半球无关。结论。具有最严重的麻痹性手臂损伤的中风幸存者必须依靠其同侧手臂进行日常活动,而受影响较小的手臂的运动障碍最大。我们建议修复该臂以改善这组卒中患者的功能独立性。
更新日期:2019-09-20
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