The role of the ipsilesional side in the rehabilitation of post-stroke subjects

Most stroke lesions occur in the middle cerebral artery territory, presenting a high probability of damage of pathways with predominant ipsilesional disposition, mainly related to postural control. Despite the high probability of bilateral postural control dysfunction based on neuroanatomical fundaments, both research and clinical rehabilitation involving stroke subjects have been focused on contralesional side (also named affected side) impairments, while ipsilesional side (also named non-affected side) impairments have been attributed to an adaptive strategy. This paper aims to present a critical understanding about the state-of-the-art that sustains the hypothesis that stroke subjects with middle cerebral artery territory lesion at the subcortical level show an atypical behaviour in the ipsilateral side associated with the lesion itself and the possible implications.