Deans' stroke musings: Contralesional and Ipsilesional Hand Depends on the Side of Stroke in Chronic Stroke Survivors With Mild-to-Moderate Impairment

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Tuesday, January 14, 2020

Contralesional and Ipsilesional Hand Depends on the Side of Stroke in Chronic Stroke Survivors With Mild-to-Moderate Impairment

Rini Varghese¹^* and

Carolee J. Winstein^1,2

¹Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, United States
²Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States

There is growing evidence that after a stroke, sensorimotor deficits in the ipsilesional hand are related to the degree of impairment in the contralesional upper extremity. Here, we asked if the relationship between the motor capacities of the two hands differs based on the side of stroke. Forty-two pre-morbidly right-handed chronic stroke survivors (left hemisphere damage, LHD = 21) with mild-to-moderate paresis performed distal items of the Wolf Motor Function Test (dWMFT). We found that compared to RHD, the relationship between contralesional arm impairment (Upper Extremity Fugl-Meyer, UEFM) and ipsilesional hand motor capacity was stronger (

R_{L H D}^{2} =

0.42;

R_{R H D}^{2}

< 0.01; z = 2.12; p = 0.03) and the slope was steeper (t = −2.03; p = 0.04) in LHD. Similarly, the relationship between contralesional dWMFT and ipsilesional hand motor capacity was stronger (

R_{L H D}^{2} =

0.65;

R_{R H D}^{2}

= 0.09; z = 2.45; p = 0.01) and the slope was steeper (t = 2.03; p = 0.04) in LHD compared to RHD. Multiple regression analysis confirmed the presence of an interaction between contralesional UEFM and side of stroke (β₃ = 0.66 ± 0.30; p = 0.024) and between contralesional dWMFT and side of stroke (β₃ = −0.51 ± 0.34; p = 0.05). Our findings suggest that the relationship between contra- and ipsi-lesional motor capacity depends on the side of stroke in chronic stroke survivors with mild-to-moderate impairment. When contralesional impairment is more severe, the ipsilesional hand is proportionally slower in those with LHD compared to those with RHD.