Is the Assessment of the Non-Paretic Lower Limb in Patients After Stroke Important When Planning Rehabilitation?

(1) Background: Hemiparetic patients after stroke have deficits on the side of the body opposite to the brain lesion. The aim of this study is to assess the occurrence of deficits in the ipsilesional lower limb. (2) Methods: Twenty-nine stroke patients (SG) and 29 healthy volunteers (CG) were recruited for this study. Passive (PROM), active (AROM), fast range of motion (FROM), and joint position sense (JPS) in the knee joint were measured using a wireless motion system. Participants were also assessed using the step test, balance platform, and the isometric protocol of measuring the strength of the extensor and flexor muscles of the knee. We compared non-paretic lower limb outcomes to the paretic side and a control group. (3) Results: The results showed a difference between the results of the ipsilesional side of the body of stroke patients and the control group. In the non-paretic limb, we observed deficits in PROM (p = 0.018) and AROM (p = 0.048), a lower average (p < 0.001) and maximum speed (p < 0.001) in FROM, worse proprioception (JPS, p < 0.001), and a lower number of repetitions in the step test (p < 0.001) compared to the control group. We also observed a decrease in the average isometric strength of the extensor (p < 0.001) and flexor (p = 0.040) muscles of the non-paretic knee joint compared to the CG. The balance assessment on a balance platform showed worse postural control in people after stroke in all tested conditions (eyes open and closed on a firm and foam surface; p < 0.001). (4) Conclusions: The non-paretic lower limb in stroke patients is characterized by limited ROM at the knee joint, reduced movement speed, decreased proprioception, weakness of the knee flexors and extensors, and resulting impaired balance. The deficits identified require improvement and should be considered when planning rehabilitation.

Ipsilateral deficits of targeted movements after stroke

OBJECTIVE

To test the hypotheses that targeted movements of both the ipsilateral and the contralateral extremities of stroke survivors would be prolonged compared with those from a control group without stroke, and that the ipsilateral deficit would occur in movements toward small, but not large, targets.

DESIGN

Descriptive study.

SETTING

Motor performance laboratory.

PARTICIPANTS

Convenience sample of right-handed individuals including 10 who were more than 6 months poststroke with Fugl-Meyer Motor Assessment scores greater than 75% for the upper (UEs) and lower (LEs) extremities, and a comparison group of 20 age-matched adults without stroke.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

The average time required for the stylus, held with the hand or strapped to the foot, to travel from leaving 1 target to contacting the second target (ie, movement time) and the average time the stylus rested on the target (ie, dwell time).

RESULTS

Regardless of target size, movement and dwell times for both UEs of the stroke group were prolonged compared with those of the comparison group. Regardless of target size, dwell time for both LEs of the stroke group was prolonged compared with that of the comparison group.

CONCLUSIONS

After stroke, the ipsilateral extremities may show subtle deficits in targeted movements.