Chronic Poststroke Deficits in Gross and Fine Motor Control of the Ipsilesional Upper Limb

Objectives Individuals with stroke often experience contralesional and ipsilesional arm motor deficits. The aim of this study was to compare fine and gross motor hand dexterity of the ipsilesional hand post-stroke with controls, normative values, and the contralesional hand. Design Data were collected from right-handed individuals with chronic stroke (n = 20), age-/sex-matched controls (n = 10), and normative values (n = 20) performing the Nine-Hole Peg Test and the Box and Blocks Test. Results Individuals with stroke demonstrated poorer performance with the ipsilesional arm relative to both the control group (mean difference [95% confidence interval]: Nine-Hole Peg Test [seconds], 3.4 [-0.5 to 7.3]; Box and Blocks Test [number of blocks], -12.3 [-20.3 to -4.2]) and normative values (mean difference [95% confidence interval]: Nine-Hole Peg Test [seconds], 6.5 [4.0-9.1]; Box and Blocks Test (number of blocks), -15.3 [-20.1 to -10.5]). Ipsilesional arm performance was significantly better than performance with the contralesional arm (mean difference [95% confidence interval]: Nine-Hole Peg Test [seconds], -9.4 [-20.2 to 1.4]; Box and Blocks Test (number of blocks), 33.2 [20.9-45.5]). Conclusion These findings identify residual deficits in fine and gross dexterity of the ipsilesional hand in commonly used outcome measures of hand manipulation among individuals with chronic stroke. Possible underlying mechanisms and clinical relevance are discussed.

Automated summary

Individuals with chronic stroke showed poorer fine and gross motor hand dexterity in their ipsilesional hand compared to controls and normative values, but performed significantly better than their contralesional hand. These findings suggest residual deficits in hand manipulation abilities post-stroke.