title: Contralesional Arm Preference Depends on Hemisphere of Damage and Target Location in Unilateral Stroke Patients.
abstract: Background 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.
authors: Pennsylvania State University, University Park, PA, USA.
authors: Saandeep
authors: S
authors: Mani
authors: Pennsylvania State University, University Park, PA, USA.
authors: Andrzej
authors: A
authors: Przybyla
authors: Penn State College of Medicine, Hershey, PA, USA.
authors: David C
authors: DC
authors: Good
authors: NM VA Healthcare System, Albuquerque, NM, USA University of New Mexico, Albuquerque, NM, USA.
authors: Kathleen Y
authors: KY
authors: Haaland
authors: Pennsylvania State University, University Park, PA, USA Penn State College of Medicine, Hershey, PA, USA rls45@psu.edu.
authors: Robert L
authors: RL
authors: Sainburg
mesh_terms: D000368:Aged; D001132:Arm / Q000503:physiopathology*; D002755:Choice Behavior / Q000502:physiology*; D006801:Humans; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D010291:Paresis / Q000209:etiology / Q000473:pathology / Q000503:physiopathology*; D011597:Psychomotor Performance / Q000502:physiology*; D020521:Stroke / Q000150:complications / Q000473:pathology / Q000503:physiopathology*; D014796:Visual Perception / Q000502:physiology*
keywords: arm preference; rehabilitation; stroke