Disorders of fine motor skills after a stroke: the processes of neuroplasticity and sensorimotor integration

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Abstract

Background. Impairment of fine motor skills in the hand is one of the most frequent causes of the persistent loss of professional skills, social maladjustment, and the impossibility of self-care in patients after a stroke, which ultimately leads to a significant reduction in the quality of their life. The article discusses the features of the fine motor skills’ impairment in the hand in patients after a stroke, in the context of a lateralized hemispheric lesion.

Methods. We have studied 26 patients after a primary ischemic stroke in the pool of middle cerebral artery of the right (n=12) or left (n=14) brain hemisphere. The average age of patients was 55.7±7.3 years. Patients with a right-sided ischemic stroke were comparable to those with a left-sided stroke in their age, disease duration, size of the lesion and the gender ratio.

Results. All the patients after an ischemic stroke had motor impairment in the form of a hemiparesis of a mild or moderate degree.

Discussion. We suggest the existence of differentiated mechanisms for the development of fine and highly coordinated voluntary movements in the hand of patients after an ischemic stroke, depending on the lateralization of the supratentorial lesion: diffuse deficit of the afferent support in a right-sided ischemic stroke vs. bilateral efferent deficit for a left hemisphere lesion.

Conclusion. The obtained data on the differentiated mechanisms for the development of fine and highly coordinated voluntary movements in the hand of patients after an ischemic stroke warrant the necessity of a further, more targeted research on those disorders in the post-stroke period, on order to optimize the existing rehabilitation approaches and improve the functional potential and quality of life of such patients.

About the authors

Eugeniia V. Ekusheva

Academy of Postgraduate Education under the Federal State Budgetary Institution Federal State Budgetary Unit “Federal Research and Clinical Center of Specialized Medical Care and Medical Technologies of FMBA of Russia”

Author for correspondence.
Email: ekushevaev@mail.ru
ORCID iD: 0000-0002-3638-6094
SPIN-code: 8828-0015
Scopus Author ID: 6507964640

MD, PhD, Professor, head of the department of neurology

Russian Federation, 125371, Moscow, Volokolamskoye sh., 91

A. A. Komazov

Academy of Postgraduate Education under the Federal State Budgetary Institution Federal State Budgetary Unit “Federal Research and Clinical Center of Specialized Medical Care and Medical Technologies of FMBA of Russia”

Email: ekushevaev@mail.ru

ассистент кафедры нервных болезней Академии постдипломного образования Академии постдипломного образования ФГБУ «Федеральный научно-клинический центр специализированных видов медицинской помощи и медицинских технологий Федерального медико-биологического агентства»

Russian Federation, 125371, Moscow, Volokolamskoye sh., 91

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Copyright (c) 2019 Ekusheva E.V., Komazov A.A.

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