Chronic Poststroke Deficits in Gross and Fine Motor Control of the Ipsilesional Upper Limb.

Am J Phys Med Rehabil

From the Department of Physical Therapy & Rehabilitation Science, The University of Maryland School of Medicine, Baltimore, Maryland (BPJ, KPW); and Human Cortical Physiology and Neurorehabilitation Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Beth

Published: April 2021


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Article Abstract

Objectives: Individuals with stroke often experience contralesional and ipsilesional arm motor deficits. The aim of this study was to compare fine and gross motor hand dexterity of the ipsilesional hand post-stroke with controls, normative values, and the contralesional hand.

Design: Data were collected from right-handed individuals with chronic stroke (n = 20), age-/sex-matched controls (n = 10), and normative values (n = 20) performing the Nine-Hole Peg Test and the Box and Blocks Test.

Results: Individuals with stroke demonstrated poorer performance with the ipsilesional arm relative to both the control group (mean difference [95% confidence interval]: Nine-Hole Peg Test [seconds], 3.4 [-0.5 to 7.3]; Box and Blocks Test [number of blocks], -12.3 [-20.3 to -4.2]) and normative values (mean difference [95% confidence interval]: Nine-Hole Peg Test [seconds], 6.5 [4.0-9.1]; Box and Blocks Test (number of blocks), -15.3 [-20.1 to -10.5]). Ipsilesional arm performance was significantly better than performance with the contralesional arm (mean difference [95% confidence interval]: Nine-Hole Peg Test [seconds], -9.4 [-20.2 to 1.4]; Box and Blocks Test (number of blocks), 33.2 [20.9-45.5]).

Conclusion: These findings identify residual deficits in fine and gross dexterity of the ipsilesional hand in commonly used outcome measures of hand manipulation among individuals with chronic stroke. Possible underlying mechanisms and clinical relevance are discussed.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC12404851PMC
http://dx.doi.org/10.1097/PHM.0000000000001569DOI Listing

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