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

Well shit, this connection between sensorimotor deficits and motor recovery  was written about way back in 2001. Margaret Yekutiel wrote a whole book about this, 'Sensory Re-Education of the Hand After Stroke'. We don't care about whatever relationships you found, we need protocols that deliver recovery.

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

Rini Varghese^1* 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 (R2LHD=
0.42; R2RHD < 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 (R2LHD= 0.65; R2RHD = 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.