Article

OBJECTIVE: To determine whether the preferred pattern of arm use after unilateral
hemispheric damage was associated with better everyday functioning. Our previous
work showed that right-handed stroke patients with right hemisphere damage (RHD)
used their right, ipsilesional arm most frequently, while those with left
hemisphere damage (LHD) used both arms together most frequently. This effect was
explained by right-hand preference, but its relationship to functional
performance is not known. DESIGN: Observational cohort. SETTING: Research
laboratory. PARTICIPANTS: Stroke patients (n=60; 30 RHD, 30 LHD) and healthy
controls (n=52). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The Functional Impact Assessment was used to assess performance on instrumental
activities of daily living (IADLs). RESULTS: The preferred patterns of arm use
were similar to those in our previous report. However, it was the greater use of
both arms together that was associated with better IADL performance in both
stroke groups. Ipsilesional arm use alone was not significantly associated with
IADL performance in the RHD group and was associated with poorer performance in
the LHD group. CONCLUSIONS: The modal arm use pattern did not always optimize
IADL functioning. Better IADL functioning in both stroke groups was associated
with the use of both arms together, which is the most common arm use pattern of
healthy individuals doing these same IADLs. An important practical question that
arises from these findings is whether bilateral arm rehabilitation should be
emphasized, because using both arms together is the best predictor of better
performance on everyday tasks.
CI - Copyright (c) 2012 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS