Impairments of the ipsilesional upper-extremity in the first 6-months post-stroke

Journal of NeuroEngineering and Rehabilitation

Research

Stephen H. Scott¹  Sean P. Dukelow²  Donovan B. Smith²  Jennifer A. Semrau³ 

[1] Department of Biomedical and Molecular Sciences, Queen’s University, Kingston, ON, Canada;Department of Clinical Neurosciences, Hotchkiss Brain Institute, University of Calgary, 1403 29th Street NW, Foothills Medical Centre, South Tower, Room 905, T2N 2T9, Calgary, AB, Canada;Department of Kinesiology and Applied Physiology, University of Delaware, Newark, Delaware, USA;

关键词: Stroke;    Rehabilitation;    Ipsilesional;    Robotics;    Reaching;    Motor impairment;   

DOI  :  10.1186/s12984-023-01230-8

 received in 2023-05-12, accepted in 2023-08-04,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundIpsilesional motor impairments of the arm are common after stroke. Previous studies have suggested that severity of contralesional arm impairment and/or hemisphere of lesion may predict the severity of ipsilesional arm impairments. Historically, these impairments have been assessed using clinical scales, which are less sensitive than robot-based measures of sensorimotor performance. Therefore, the objective of this study was to characterize progression of ipsilesional arm motor impairments using a robot-based assessment of motor function over the first 6-months post-stroke and quantify their relationship to (1) contralesional arm impairment severity and (2) stroke-lesioned hemisphere.MethodsA total of 106 participants with first-time, unilateral stroke completed a unilateral assessment of arm motor impairment (visually guided reaching task) using the Kinarm Exoskeleton. Participants completed the assessment along with a battery of clinical measures with both ipsilesional and contralesional arms at 1-, 6-, 12-, and 26-weeks post-stroke.ResultsRobotic assessment of arm motor function revealed a higher incidence of ipsilesional arm impairment than clinical measures immediately post-stroke. The incidence of ipsilesional arm impairments decreased from 47 to 14% across the study period. Kolmogorov–Smirnov tests revealed that ipsilesional arm impairment severity, as measured by our task, was not related to which hemisphere was lesioned. The severity of ipsilesional arm impairments was variable but displayed moderate significant relationships to contralesional arm impairment severity with some robot-based parameters.ConclusionsIpsilesional arm impairments were variable. They displayed relationships of varying strength with contralesional impairments and were not well predicted by lesioned hemisphere. With standard clinical care, 86% of ipsilesional impairments recovered by 6-months post-stroke.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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