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Laterality of Damage Influences the Relationship Between Impairment and Arm Use After Stroke

Published online by Cambridge University Press:  31 January 2019

Goldy Yadav Open the ORCID record for Goldy Yadav [Opens in a new window] ,
Kathleen Y. Haaland  and
Pratik K. Mutha
Goldy Yadav
Affiliation:
Center for Cognitive Science, Indian Institute of Technology Gandhinagar, Gujarat, India
Kathleen Y. Haaland
Affiliation:
Department of Psychiatry & Behavioral Sciences and Neurology, University of New Mexico, Albuquerque, New Mexico
Pratik K. Mutha*
Affiliation:
Center for Cognitive Science, Indian Institute of Technology Gandhinagar, Gujarat, India Department of Biological Engineering, Indian Institute of Technology Gandhinagar, Gujarat, India
*
*Correspondence and reprint requests to: Pratik K. Mutha, Block 5, Room 316A, Indian Institute of Technology Gandhinagar, Palaj, Gandhinagar – 382355, Gujarat, India. E-mail: [email protected]
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Abstract

Objectives: To investigate whether the relationship between arm use and motor impairment post-stroke is influenced by the hemisphere of damage. Methods: Right-handed patients with unilateral left hemisphere damage (LHD) or right (RHD) (n=58; 28 LHD, 30 RHD) were recruited for this study. The Arm Motor Ability Test and Functional Impact Assessment were used to derive arm use patterns. The Fugl-Meyer motor assessment scale was used to quantify the level of motor impairment. Results: A significant interaction between patient group and impairment level was observed for contralesional, but not ipsilesional arm use. For lower impairment levels, contralesional (right arm for LHD and left arm for RHD) arm use was greater in LHD than RHD patients. In contrast, for greater levels of impairment, there were no arm use differences between the two patient groups. Conclusions: When motor impairment is significant, it overrides potential effects of stroke laterality on the patterns of arm use. However, a robust influence of hemisphere of damage on the patterns of arm use is evident at lower impairment levels. This may be attributed to previously described arm preference effects. These findings suggest adoption of distinct strategies for rehabilitation following left versus right hemisphere damage in right-handers, at least when the impairment is moderate to low. (JINS, 2019, 25, 470–478)

Keywords

ArmMovementRehabilitationFunctional lateralityParesisActivities of Daily Living (ADL)
Type
Regular Research
Information
Journal of the International Neuropsychological Society , Volume 25 , Issue 5 , May 2019 , pp. 470 - 478
Copyright
Copyright © The International Neuropsychological Society 2019 

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