Hemispheric especialization in assessing reach and grip in post-stroke patients: a cross-sectional observational study
Stroke; Cerebral Dominance, Functional Laterality
Abstract: Unilateral brain injuries affecting the left hemisphere bring different clinical conditions than those affecting the right hemisphere. It is postulated that the left hemisphere is more responsible for the range acceleration phase and the right hemisphere for the deceleration (grip) phase. This statement stems from kinematic studies of human movement. The aim of this study was to analyze, through clinical instruments, whether patients with right hemisphere injury differ from patients with left hemispheric injury for reach and grasp movement. Methods: This is an observational cross-sectional analytical study conducted with patients who had stroke for more than six months and had unilateral impairment. Fifteen patients (nine with right injuries and six with left injuries) were selected and evaluated in the reach and bilateral grip movements using the Box and Block test (BBT) instruments, the Action Research Arm Test (ARAT), the functional range (REACH) and dynamometry. In order to compare clinical measures (ARAT, BBT and Reach Performance Scale) and hand dynamometry) between the two groups (GR x GL) and between individuals in the same group, the Mann-Whitney U test was performed. Correlation was performed by Spearman test. Results: Fifteen subjects met the eligibility criteria for the study and, as such, the subjects were divided into two groups, lesion in the right hemisphere and lesion in the left hemisphere. However, from the results found it was not possible to verify the hemispheric differences for reach and prehension activity through the clinical instruments. Conclusion: It was not possible to obtain evidence that hemispheric specialization can be measured from clinical assessment scales.