The good side after stroke: Ipsilateral sensory-motor function needs careful assessment

Twenty subjects were examined 4-6 weeks after stroke to establish whether a sensory-motor ipsilateral deficit occurs early after stroke. Each underwent a timed test of repetitive side-to-side movement of both the upper and lower limbs ipsilateral to the cerebral infarct, and an assessment of motor disability using the Motor Assessment Scale. Results were compared with a group studied almost a year after their stroke, and with 41 age-matched healthy volunteers. There was a significantly worse performance (p < 0.005) on the right ipsilateral side, but not the left ipsilateral side, compared with normal volunteers, a finding similar to that of a group previously studied about a year after the stroke. There was no relationship between the severity of the motor deficit and performance of the 'good' side. This study suggests that ipsilateral sensory-motor deficit occurs after stroke but only on the right side, possibly owing to reduction in cerebral activation as a result of a right hemispheric lesion. These observations have importance in rehabilitation and education as well as practical skills, including driving a car and maintaining balance.