Could be the predominantly-used hemibody related to the weight bearing distribution modified by the chronic hemiparesis after stroke?

Abstract

Since the first Broca publications issued from 1970s, lateralized functions in the human brain have urged the researchers to postulate hypothesis based in the right-left asymmetries and, according to some theories, the lateralization of the voluntary motor control could represent a solution to avoid redundant process optimizing space and time. Supported by this idea, the clinicians and researchers tend to concept that the chronic hemiplegic stroke patients learn to use predominantly the non-affected hemibody after stroke in which is more convenient to execute their daily life activities, modifying their natural preference in some cases. Although could seems reasonable conceptualize the non-affected side as the predominantly-used hemibody for motor tasks after stroke (convenience hypothesis), evidences point to exist also hemiplegic patients that developed a predominantly use of the affected side. To float an idea, in terms of weight bearing distribution during upright position, the researchers have found patients overloading the non-affected hemibody, as expected; but also patients overloading the affected hemibody, not presenting necessarily Pusher's syndrome cases. Given the evidences, we could propose a severity-modulated predominance hypothesis which complements the convenience hypothesis. According to our complementary hypothesis, the severity of the motor disability presented in the hemiparesis condition (light, moderate and heavy severity) could determine a predominant use defined by preference (light to moderate severity) or convenience (moderate to heavy severity). In this hypothesis, we postulate ideas from a rehabilitation perspective to be incorporated in treatment programs.