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Author Spotlight: Rehabilitation of Stroke Patients With a Digital Occupational Training System
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Stroke Lesion Impact on Lower Limb Function.

Silvi Frenkel-Toledo1,2, Shay Ofir-Geva2,3, Lihi Mansano2,3

  • 1Department of Physical Therapy, Faculty of Health Sciences, Ariel University, Ariel, Israel.

Frontiers in Human Neuroscience
|February 18, 2021
PubMed
Summary
This summary is machine-generated.

Stroke lesion location significantly impacts motor impairment and walking ability. Right hemisphere damage affects motor function more broadly than left hemisphere damage, highlighting complex brain reorganization after stroke.

Keywords:
activity limitationbrain mappingcompensationimpairmentlower extremityrestitutionstroke

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Area of Science:

  • Neuroscience
  • Rehabilitation Medicine
  • Neurology

Background:

  • Stroke frequently causes motor deficits, impacting both basic movement (impairment) and daily activities (activity limitation).
  • Recovery involves restitution for impairment and restitution plus compensation for activity limitation.
  • Understanding lesion topography's long-term effects is crucial for targeted rehabilitation.

Purpose of the Study:

  • To investigate the relationship between lesion location and long-term motor impairment of the hemiparetic lower limb (HLL) and gait capacity after stroke.
  • To differentiate the effects of left versus right hemispheric damage on HLL impairment and walking.
  • To identify specific brain structures associated with enduring motor deficits.

Main Methods:

  • Voxel-based lesion-symptom mapping (VLSM) was used in 67 chronic stroke patients.
  • Gait capacity was assessed using the 3-meter walk test (3MWT).
  • Hemiparetic lower limb (HLL) impairment was evaluated with the Fugl-Meyer Lower Extremity (FMA-LE) test.

Main Results:

  • Left hemispheric damage primarily affected HLL impairment via the posterior limb of the internal capsule (PLIC) and walking via PLIC, corona radiata, external capsule, and caudate nucleus.
  • Right hemispheric damage showed broader effects on both HLL impairment (corona radiata, superior longitudinal fasciculus, insula) and walking (including internal/external capsules, putamen, thalamus, perisylvian cortex).
  • Damage to specific brain regions impacted FMA-LE and 3MWT scores, while other regions affected only one measure, predominantly 3MWT.

Conclusions:

  • Enduring 'activity limitation' after stroke is linked to damage in a wider range of brain structures than 'impairment'.
  • Differences between left and right hemisphere damage suggest variations in motor network organization and hemispheric dominance.
  • Further research with larger cohorts is needed to validate these findings on stroke recovery and brain lesion impacts.