Motor impairment of the ipsilesional body side in poststroke subjects

Abstract

In poststroke hemiparetic patients, motor weakness usually occurs on the contralesional body side to the brain. Impairment on the ipsilateral body side also occurs, but less than the contralateral side. The level and type of deficits on the less-affected side is still unclear. Clinicians usually do not consider the less-affected side for assessment and management. The main purpose is to explore the motor weakness (coordination, gross and fine motor dexterity, and muscle strength) of the less-affected side. The secondary aim is to determine the relationship between the impairments of both body sides (affected and less-affected). A prospective, cross-sectional, and nonexperimental study was conducted at an outpatient occupational therapy unit of a rehabilitation institute. A convenient sample of 27 poststroke (19.0±14.28months) subjects (21 males and 6 females, 22 right-sided and 5 left-sided hemiparesis) was recruited. Outcome measures for the less-affected side were Minnesota Manual Dexterity Test (MMDT), Purdue PegBoard Test (PPBT) and Manual Muscle Testing (MMT). Brunnstrom Recovery Stage (BRS) and Fugl-Meyer Assessment (FMA) were applied for the affected side. The less-affected side of the poststroke subjects was compared with the side-, age-, and gender-matched controls. The results showed highly significant (p<0.001) difference between the scores of the ipsilesional body side of the poststroke subjects (MMDT=105.21±22.70s, PPBT=9.30±2.47, and median MMT grade range from 3 to 4) and the matched side of the controls (MMDT=72.41±11.69s, PPBT=13.78±1.76, and median MMT grade 5). The findings also suggested no significant relation between the motor deficits of the less-affected and affected sides. The ipsilesional body side of poststroke subjects had impaired coordination, gross and fine motor dexterity, and the upper and lower limb muscle strength. The side must be assessed and managed accordingly. Management would promote motor and functional recovery on both the sides.