Robotic Characterization of Ipsilesional Motor Function in Subacute Stroke

Area of Science:

• Neurorehabilitation
• Stroke recovery
• Motor control

Background:

• Ipsilesional arm impairments post-stroke are under-rehabilitated despite affecting daily function.
• Subtle ipsilesional motor deficits in the subacute stroke phase are poorly characterized.
• Traditional clinical measures may miss nuanced motor function deficits.

Purpose of the Study:

• To quantify reaching deficits in both the contralesional and ipsilesional limbs during the subacute phase post-stroke.
• To compare robotic measures of motor function with traditional clinical assessments.

Main Methods:

• 227 first-time, unilateral stroke subjects underwent visually guided reaching tasks using a KINARM robot.
• Both ipsilesional and contralesional arms were assessed for motor function.
• Robotic measures were compared against traditional clinical scales (FIM, CMSA, Purdue Pegboard, BIT).

Main Results:

• Ipsilesional arm deficits were prevalent, affecting 37% of subjects.
• Robotic assessments showed weak to moderate correlations between ipsilesional and contralesional arm impairments.
• Contralesional arm impairment magnitude did not predict ipsilesional deficits; lesion location influenced ipsilesional impairment prevalence.

Conclusions:

• Contralesional arm impairment and lesion location are weak predictors of ipsilesional deficits.
• Characterizing ipsilesional deficits is crucial for identifying patients who could benefit from rehabilitation of the less affected arm.
• Robotic assessments offer sensitive quantification of subtle motor impairments post-stroke.