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455 ASSESSING POST-STROKE IPSILESIONAL MOTOR SEQUENCING DEFICITS.
  1. C. A. Chestnut*,
  2. K. Y. Haaland**
  1. *University of New Mexico School of Medicine
  2. **Psychology and Research Service, Veterans Affairs Medical Center, Departments of Neurology and Psychology and Psychiatry, University of New Mexico School of Medicine, Albuquerque, NM

Abstract

Purpose Ipsilesional motor deficits that are present following a unilateral stroke affect activities of daily living and potentially independent functioning. Ipsilesional deficits may be due to impairment in higher-level cognitive processes, such as motor planning. This study focuses on the Williams Door task to investigate sequencing deficits in the ipsilesional limb following a unilateral stroke. We hypothesized that limb apraxia would best predict impaired performance after left hemisphere damage (LHD) when aphasia, spatial deficits, and simple motor deficits were also considered. For the right hemisphere-damaged (RHD) group, we predicted that ipsilesional motor deficits, spatial deficits, or both would be predictors of performance.

Methods We examined 114 right-handed subjects: 31 patients with LHD due to stroke, 21 patients with RHD due to stroke, and 62 able-bodied control (ABC) subjects. Data obtained included ideomotor limb apraxia, aphasia, spatial ability, and right and left motor ability. The primary dependent measure is the Williams Doors Task.

Results Both LHD and RHD groups demonstrated ipsilesional deficits on the Williams Doors task (p < .001). The two groups had comparably poor performances relative to the ABC group; however, the predictors of poor performance were different for the two groups. Using a stepwise regression analysis, limb apraxia and spatial skills were the best predictors of performance for the LHD group and left motor ability was the best predictor of RHD performance.

Conclusions Comparable ipsilesional deficits were present after left or right hemisphere damage, but the predictors of such performance were different. Whereas limb apraxia and spatial deficits best predicted the performance of the LHD group, left motor skills best predicted ipsilesional performance of the RHD group. The Williams Door task is a good global measure of ipsilesional limb impairment after a right or left hemisphere stroke and can be used as an additional measure for evaluating ipsilesional limb-sequencing ability for potential rehabilitation.

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