The Correlation of Recovery of Ipsilateral Motor Weakness and That of Contralateral Hemiplegia in Stroke

OBJECTIVE: We observed the nature of ipsilateral weakness, not hemiplegic side after stroke. And we studied correlation between ipsilateral weakness and neurologic recovery of hemiplegia. METHOD: This study was prospective, follow-up clinical trial. Ipsilateral motor power was checked serially in 20 subjects using Nicholas Manual Muscle Tester (NMMT) (shoulder abduction, wrist extension, hip flexion, ankle dorsiflexion). The subjects are first attacked hemiplegic stroke patients. Other outcome measures are Mini-mental Status Examination (MMSE) and National Institutes of Health Stroke Scale (NIHSS). We studied correlations between motor power recovery in ipsilateral limbs and recovery of neurologic impairment in hemiplegic limbs of stroke patients through SPSS 7.0 program. RESULTS: Ipsilateral motor power in early stage stroke patients is significantly low compared with that of normal subject except ankle dorsiflexion (p<0.05). Comparing ipsilateral proximal with distal limbs power in pre and post multidisciplinary rehabilitation program, upper proximal part recovered faster than the distal part, but which was not statistically significant. Recovery of ipsilateral upper proximal and distal limb weakness is associated with neurologic recovery in hemiplegic side. CONCLUSION: After the stroke, ipsilateral upper limb motor weakness does occur and which follows similar neurologic recovery pattern to the hemiplegic side. Ipsilateral cortical and subcortical tracts take effect on the neurologic recovery of contalateral side.

Recovery from Motor Weakness of Ipsilateral Upper Limb Following Stroke Comparison on Recovery of Proximal Portion with That of Distal Portion

OBJECTIVE: To observe the ipsilateral upper limb function after stroke comparing proximal with distal part and to determine how they recover after stroke. METHOD: Cohort study of 72 patients with stroke in the middle cerebral arterial territory undergoing multidisciplinary stroke rehabilitation program. The main outcome was assessed by the Manual Function Test (MFT) for upper limb function, weekly. RESULTS: The recovery time of the ipsilateral upper limb to maximum function was 32.4+/-15.4 days. The functions of the ipsilateral shoulder and hand after stroke decreased significantly. Even at the maximum recovery, complete recovery was not seen. For ipsilateral shoulder, more severe functional deficits were seen with subcortical lesion than with cortical lesion, whereas for ipsilateral hands, no difference was seen between them. CONCLUSION: Therefore, the fact that recoveries of the shoulders and hands were different according to the presence of cerebral cortical or subcortical lesions suggests that the brain structures that control these areas or the recovery mechanisms might be different.