Article

Previous research has shown that during simulated activities of daily
living, right-handed stroke patients use their contralesional arm more after
left- than right-hemisphere stroke. These findings were attributed to a hand
preference effect. However, these decisions about when to use the contralesional
arm may be modulated by where in the work space the task is performed, a factor
that could be used in physical rehabilitation to influence recovery by decreasing
learned nonuse. Objective. To examine how target location and side of stroke
influences arm selection choices for simple reaching movements. Methods. A total
of 14 right-handed stroke patients (7 with left-hemisphere and 7 with
right-hemisphere damage [RHD]), with similar degrees of hemiparesis (Fugl-Meyer
motor score), and 16 right-handed controls participated in this experiment. In a
pseudorandom fashion, 32 targets were presented throughout the reachable
horizontal plane work space, and the participants were asked to select 1 hand to
reach the target on each trial. Results. The group with left-hemisphere damage
chose their contralesional arm significantly more often than the group with RHD.
Patients with RHD also chose their left (contralesional) arm significantly less
often than the control group. However, these patterns of choice were most
pronounced in the center of the workspace. Conclusion. Both the side of
hemisphere damage and work space location played a significant role in the choice
of whether to use the contralesional arm for reaching. These findings have
implications for structuring rehabilitation for unilateral stroke patients.
CI - (c) The Author(s) 2014.

Langue : ANGLAIS