Limb Muscle Strength is Impaired Bilaterally after Stroke

抄録

The purpose of this study was to describe the nature and implications of strength deficits on the sides ipsilateral and contralateral to stroke. Subjects consisted of 16 patients who experienced a first stroke (2-40 days before testing) with hemiparesis (7 left, 9 right). The strengths of proximal (shoulder abduction, hip flexion), middle (elbow flexion and knee extension), and distal (wrist extension, ankle dorsiflexion) muscle actions were measured by hand-held dynamometry. Muscle strength deficits were calculated by subtracting measured forces from predicted forces determined from regression equations. The Functional Independence Measure was used to grade independence in transfers and gait. Analysis of variance (ANOVA) showed that the patients’ strength was impaired bilaterally. Further ANOVAs demonstrated that impairments did not differ significantly from proximal to distal on the side contralateral to the lesion but that impairments were significantly greater proximally than distally on the side ipsilateral to the lesion. Muscle strength impairments tended to correlate significantly with one another (within and between sides) and with functional independence. The results challenge some traditional views of the muscle strength deficits that accompany stroke.