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Individuals with the Dominant Hand Affected following Stroke Demonstrate Less Impairment Than Those with the Nondominant Hand Affected

School of Rehabilitation Sciences, University of British Columbia, Vancouver, Canada, Rehabilitation Research Lab, G. F. Strong Rehab Centre, Vancouver, British Columbia, Canada

Janice J. Eng, PhD, PT/OT

School of Rehabilitation Sciences, University of British Columbia, Vancouver, Canada, Rehabilitation Research Lab, G. F. Strong Rehab Centre, Vancouver, British Columbia, Canada, Janice.Eng{at}vch.ca

Objective. The purpose was to determine if upper extremity impairment and function in individuals with chronic stroke is dependent upon whether the dominant or non-dominant hand is affected. Methods. Ninety-three community-dwelling individuals with stroke. The Modified Ashworth Scale (tone), handheld dynamometry (isometric strength), monofilaments (sensation), Brief Pain Inventory (pain), Chedoke Arm and Hand Activity Inventory Motor Activity Log (paretic arm use), and Reintegration to Normal Living Index (participation) were used to form impairment and function models. Results. Multivariate analysis models (Dominance x Severity) were created for impairment and function variables. There was a significant interaction and main effect of Dominance for the impairment model (P = 0.01) but not the function model (P = 0.75). The dependent variables of tone, grip strength, and pain were all significantly affected by Dominance, indicating less impairment if the dominant hand was affected. All dependent variables except pain were affected by Severity. Conclusion. This study looked at the effect of the dominant hand being affected versus the nondominant in individuals with chronic stroke. Individuals with the dominant hand affected demonstrated less impairment than those with the nondominant hand affected. However, there was no effect of dominance on paretic arm use or performance in activities of daily living. Prospective studies to further explore the issue of hand dominance and poststroke function are suggested.

Key Words: Stroke • Upper extremity • Laterality • Rehabilitation

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