Previous lower limb dominance does not affect measures of impairment and activity after stroke
Kênia K Menezes1, Christina D Faria1, Aline A Scianni1
1Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Background:
Similar to the findings with the upper limbs, previous dominance of the lower limbs could also interfere with measures of impairment and activity of individuals with stroke. If this occurs, rehabilitation interventions should be planned, considering previous lower limb dominance.
Aim:
To investigate the impact of having the dominant versus the non-dominant lower limb affected by the stroke on measures of impairment and activity.
Design:
Cross-sectional study.
Setting:
University laboratory.
Population:
Ninety subjects with chronic stroke, divided into dominant (n=44) and non-dominant (N.=46) groups.
Methods:
The sub-groups were classified according to the severity of motor impairments into mild and severe. Impairment measures included sensation, tonus, isometric strength and motor coordination, whereas activity measures included walking speed, and stair ascent/descent cadences.
Results:
The MANOVAs did not reveal any significant interactions between dominance and severity of motor impairments for both the impairment and activity models. Significant main effects of severity of motor impairments were found for both the impairment and activity models, but not for dominance. All dependent variables were significantly affected by the severity of motor impairments, but not by dominance.
Conclusions:
The findings suggested that individuals, who had their dominant lower limb affected by the stroke, demonstrated similar impairments, than those who had the non-dominant lower limb affected. Furthermore, significant effects of severity of motor impairments, but not of dominance, were found on all measures of impairment and activity.
Clinical Rehabilitation Impact:
The findings emphasize the importance of not training the lower limbs based upon previous dominance, but giving priority to bilateral training. When both limbs are simultaneously used in tasks, the movement of the non-dominant limb improves the quality of the movement, accuracy, and speed, because bilateral training helps the unaffected side to train the affected side.
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