Varghese Rini, Winstein Carolee J
Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, United States.
Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States.
Front Neurol. 2020 Jan 8;10:1340. doi: 10.3389/fneur.2019.01340. eCollection 2019.
There is growing evidence that after a stroke, sensorimotor deficits in the ipsilesional hand are related to the degree of impairment in the contralesional upper extremity. Here, we asked if the relationship between the motor capacities of the two hands differs based on the side of stroke. Forty-two pre-morbidly right-handed chronic stroke survivors (left hemisphere damage, LHD = 21) with mild-to-moderate paresis performed distal items of the Wolf Motor Function Test (dWMFT). We found that compared to RHD, the relationship between contralesional arm impairment (Upper Extremity Fugl-Meyer, UEFM) and ipsilesional hand motor capacity was stronger ( 0.42; < 0.01; = 2.12; = 0.03) and the slope was steeper ( = -2.03; = 0.04) in LHD. Similarly, the relationship between contralesional dWMFT and ipsilesional hand motor capacity was stronger ( 0.65; = 0.09; = 2.45; = 0.01) and the slope was steeper ( = 2.03; = 0.04) in LHD compared to RHD. Multiple regression analysis confirmed the presence of an interaction between contralesional UEFM and side of stroke (β = 0.66 ± 0.30; = 0.024) and between contralesional dWMFT and side of stroke (β = -0.51 ± 0.34; = 0.05). Our findings suggest that the relationship between contra- and ipsi-lesional motor capacity depends on the side of stroke in chronic stroke survivors with mild-to-moderate impairment. When contralesional impairment is more severe, the ipsilesional hand is proportionally slower in those with LHD compared to those with RHD.
越来越多的证据表明，中风后，患侧手的感觉运动功能障碍与对侧上肢的损伤程度有关。在此，我们探讨了基于中风部位，双手运动能力之间的关系是否存在差异。42名病前惯用右手的慢性中风幸存者（左半球损伤，LHD = 21），有轻度至中度轻瘫，进行了沃尔夫运动功能测试（dWMFT）的远端项目。我们发现，与右侧半球损伤（RHD）相比，LHD患者对侧手臂损伤（上肢Fugl-Meyer评估量表，UEFM）与患侧手运动能力之间的关系更强（r = 0.42；p < 0.01；t = 2.12；df = 0.03），且斜率更陡（β = -2.03；p = 0.04）。同样，与RHD相比，LHD患者对侧dWMFT与患侧手运动能力之间的关系更强（r = 0.65；p = 0.09；t = 2.45；df = 0.01），且斜率更陡（β = 2.03；p = 0.04）。多元回归分析证实，对侧UEFM与中风部位之间存在交互作用（β = 0.66 ± 0.30；p = 0.024），对侧dWMFT与中风部位之间也存在交互作用（β = -0.51 ± 0.34；p = 0.05）。我们的研究结果表明，在轻度至中度损伤的慢性中风幸存者中，对侧和患侧运动能力之间的关系取决于中风部位。当对侧损伤更严重时，与RHD患者相比，LHD患者的患侧手相应地更慢。
