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Movement deficits in the ipsilesional “less-affected” arm after stroke. Part of the Stroke Arm Longitudinal study at Gothenburg University, SALGOT-study

Conference contribution
Authors Margit Alt Murphy
Eva-Lena Bustrén
Katharina S Sunnerhagen
Published in Neurorehabilitation and Neural Repair
ISSN 1545-9683
Publication year 2016
Published at Institute of Neuroscience and Physiology, Department of Clinical Neuroscience
Language en
Keywords stroke, movement, ipsilesional, kinematics, Activities of Daily Living, upper-extremity
Subject categories Clinical Medicine

Abstract

Objectives Increasing body of literature indicates that motor function at the ipsilesional side after stroke can be affected, but these deficits can be difficult to detect using traditional clinical scales. In addition, the ipsilesional side is commonly used as reference, representing a normal movement in assessments, which may affect the test results. The study aims to determine whether and to what extent the movements in the ipsilesional upper limb are affected after stroke. Methods In total, 44 individuals with stroke and 20 healthy controls were included. An optoelectronic motion capture system was used to measure kinematics and Fugl-Meyer Assessment for Upper Extremity to assess sensorimotor impairment in to subgroups (moderate 32-57, mild 58-66). Kinematic measures describing movement time, velocity, smoothness, strategy and compensatory movements in drinking task at two time points, early during the first month and at 3 months after stroke, were analyzed. Results The entire stroke group showed ipsilesional deficits in 6 and the subgroup of moderate impairment in 9 of the 12 kinematic measures early after stroke. In moderate impairment group the movements were slower, less smooth, the deceleration phase was longer and a larger abduction of the arm was used during drinking activity compared to healthy controls. A statistically significant improvement was also detected over time in 6 kinematic measures, but a deficit was still present in angular velocity of elbow and deceleration time in reaching 3 months poststroke. Conclusions This study demonstrates that motor deficits are common in ipsilesional upper extremity early after stroke and these deficits are more prominent in persons with poor controlesional motor function. The ipsilesional arm should be assessed early after stroke, preferably using measures that are sensitive to detect minor deficits. Clinical scales using the “less-affected” arm as reference, indicating normal movement, should be used with caution early after stroke.

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