Stroke
Conditions
Keywords
Stroke, Handedness, Motricity, Upper Limb, Manual preference, Motor impairment, Motor recovery
Brief summary
This prospective, single-center observational study evaluates whether handedness is associated with upper-limb motor recovery after a recent unilateral stroke. Adults admitted to the stroke unit with a confirmed unilateral stroke within 5 days are included if they do not object to participation. Upper-limb impairment is assessed early after stroke and at 6 months using standardized clinical scales. Handedness is determined by self-report, and the Edinburgh Handedness Inventory is administered when feasible. The main hypothesis is that left-handed participants may show better upper-limb motor recovery at 6 months than right-handed participants, potentially due to differences in brain motor network lateralization.
Detailed description
Participants hospitalized in the stroke unit with a confirmed unilateral stroke are recruited consecutively. After eligibility verification and absence of objection, baseline data are collected within 5 days post-stroke. Baseline assessments include the Fugl-Meyer Assessment for the Upper Extremity (FMA-UE), the Shoulder Abduction and Finger Extension (SAFE) score, and the National Institutes of Health Stroke Scale (NIHSS) score (post-acute treatment if thrombolysis or thrombectomy was performed). Handedness is recorded after the motor assessments to maintain assessor blinding regarding group membership; the Edinburgh Handedness Inventory is administered when cognitive status allows. A 6-month follow-up is performed during routine post-stroke consultation at the study site, with repeat FMA-UE and SAFE assessments. The primary analysis compares FMA-UE at 6 months between left-handed and right-handed participants among those with baseline FMA-UE less than 66, using propensity score matching (3:1 right-handed to left-handed) accounting for age, baseline motor deficit, lesion side relative to dominance (dominant vs non-dominant hemisphere), and stroke type (ischemic vs hemorrhagic).
Interventions
OTHERevaluation
Patients will be evaluated at baseline for Edinburgh Handedness Inventory Laterality Quotient. Patients will be seen again at 6 months as part of their standard post-stroke consultation at Orléans University Hospital by a neurologist from the neurology department. In conjunction with this consultation, an assessment specific to this research study of the FMA-UE and SAFE scores will be carried out by a physiotherapist from the department.
Sponsors
Centre Hospitalier Régional d'Orléans
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Confirmed unilateral recent stroke (less than 5 days). 2. Age 18 years and older. 3. Participant or proxy does not object to participation
Exclusion criteria
1. Prior stroke with residual motor sequelae. 2. Pre-stroke upper-limb deficit. 3. Follow-up at 6 months not planned at Orléans. 4. Protected adult (guardianship/curatorship), person under legal protection, or deprived of liberty. 5. Pregnant or breastfeeding woman.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Fugl-Meyer Assessment for Upper Extremity (FMA-UE) Score | month 6 | Upper-limb motor impairment measured using the Fugl-Meyer Assessment for the Upper Extremity (FMA-UE) at 6 months post-stroke. Scores range from 0 to 66, with higher scores indicating less impairment. Primary analysis is performed among participants with baseline FMA-UE less than 66. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Mean Fugl-Meyer Assessment for Upper Extremity (FMA-UE) Score | Baseline | Score from 0 to 66; the lower the score, the more severe the deficit |
| Proportion of Left-Handed Participants | Baseline | — |
| Mean National Institutes of Health Stroke Scale (NIHSS) Score | Baseline | Score from 0 to 42; the higher the score, the more severe the deficit |
| Number of Participants With Upper-Limb Weakness | Baseline | Number of Participants With Upper-Limb Weakness Defined as SAFE Score Less Than 10 |
| Correlation Between Edinburgh Handedness Inventory Laterality Quotient and Baseline FMA-UE Score | Baseline | Score from -100 to +100, no notion of severity here since it assesses manual preference (at -100 you are very left-handed and at +100 you are very right-handed) |
| Mean Shoulder Abduction and Finger Extension (SAFE) Score | Month 6 | Score from 0 to 10; the lower the score, the more severe the deficit. |
Countries
France
Contacts
CONTACTJulien BONNAL, MK
Outcome results
None listed