A especialização hemisférica na avaliação do alcance e preensão em pacientes pós-AVC: um estudo observacional analítico transversal

Abstract

Introduction: Unilateral brain lesions affecting the left hemisphere bring different clinical conditions than those affecting the right hemisphere. It is postulated that the left hemisphere is more responsible for the acceleration phase (reach) and the right hemisphere for the deceleration phase (grip). This statement stems from kinematic studies of human movement, and there is a gap in the lack of evidence on clinical studies evaluating range and grip movement. The aim of this study was to analyze, through clinical instruments, whether patients with right hemisphere injury differ from patients with left hemispheric injury for reach and grasp movement. Methods: This is an observational cross-sectional analytical study conducted with patients who had stroke for more than six months and had unilateral impairment. Fifteen patients (nine with right injuries and six with left injuries) were selected and evaluated in the reach and bilateral grasp movements using the Box and Block test (BBT), the Action Research Arm Test (ARAT), the functional range (REACH) and dynamometry. Comparisons of clinical measurements (ARAT, BBT and Reach) and hand dynamometry were performed between the two groups studied (GR x GL- intergroup), and between individuals in the same group (comparison between the healthy side versus the side affected by each individual). In addition, in order to observe the relationship between the measurements obtained, a correlation test was performed. Results: Fifteen subjects met the eligibility criteria for the study and, thus, the individuals were divided into two groups, DR and GL. As for the intra-group analysis, statistically significant differences were found for the BBT, Reach-AD and ARAT instruments for the DG, and BBT, Reach-AD and dynamometry for the EG. In the intergroup evaluation, statistically significant results were found for the BBT, ARAT and dynamometry scales Conclusion: It was not possible to obtain evidence that hemispheric specialization can be measured using clinical evaluation scales.