The impact of lesion side on bilateral upper limb coordination after stroke.
Pei-Cheng Shih, Christopher J Steele, Dennis Hoepfel and 3 others
PMID 38093308WHAT IT FOUND
Right hemisphere stroke made alternating two-hand circles harder to coordinate.
Left hemisphere stroke made simultaneous circles harder, especially the weaker hand's path. This pattern could help choose two-hand practice.
Key findings
01During two-hand circle drawing, the weaker hand's path was less steady in alternating movements after right hemisphere stroke and in simultaneous movements after left hemisphere stroke.
02Right hemisphere stroke impaired timing between the two hands during alternating movements, while left hemisphere stroke did not show impaired timing compared with controls.
03During simultaneous movements, left hemisphere stroke shifted the hand that best predicted two-hand coordination to the hand on the same side as the lesion.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Only 18 stroke patients were included, so the lesion-side differences need confirmation in larger groups. All stroke patients had been right-handed before stroke, so the results may not apply to left-handed or mixed-handed patients. The task used proximal arm movements in a circle-drawing setup, not fine finger movements or everyday object use. Patients were chronic stroke survivors with mild-to-moderate impairment and no neglect, so more severely affected patients were not represented. The study did not test a rehabilitation programme, so it cannot show that training based on lesion side improves function.
Declared interests
Funding was provided by the International Max Planck Research School on Neuroscience of Communication and the Max Planck Institute for Human Cognitive and Brain Sciences.
The easy way to misread this
Do not conclude that training simultaneous or alternating two-hand movements has been shown to improve stroke rehabilitation. The paper measured a lab task in a small group and did not test a treatment programme.