Functional Significance of Ipsilesional Motor Deficits After Unilateral Stroke

Abstract

Chestnut C, Haaland KY. Functional significance of ipsilesional motor deficits after unilateral stroke. ObjectiveTo determine whether ipsilesional motor skills, which have been related to independent functioning, are present chronically after unilateral stroke and are more common in people with apraxia than in those without apraxia. DesignObservational cohort comparing the performance of an able-bodied control group, stroke patients with left- or right-hemisphere damage matched for lesion volume, and left-hemisphere stroke patients with and without ideomotor limb apraxia. SettingPrimary care Veterans Affairs and private medical center. ParticipantsVolunteer right-handed sample; stroke patients with left- or right-hemisphere damage about 4 years poststroke; a control group of demographically matched, able-bodied adults. InterventionsNot applicable. Main Outcome MeasuresTotal time to perform the (1) Williams doors test and the (2) timed manual performance test (TMPT), which includes parts of the Jebsen-Taylor Hand Function Test. ResultsIpsilesional motor deficits were present after left- or right-hemisphere stroke when using both measures, but deficits were consistently more common in patients with limb apraxia only for the TMPT. ConclusionsThese findings add to a growing literature that suggests that ipsilesional motor deficits may have a functional impact in unilateral stroke patients, especially in patients with ideomotor limb apraxia.