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.
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).
Study Type
OBSERVATIONAL
Enrollment
500
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.
CHU Orléans
Orléans, France
Fugl-Meyer Assessment for Upper Extremity (FMA-UE) Score
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.
Time frame: month 6
Mean Fugl-Meyer Assessment for Upper Extremity (FMA-UE) Score
Score from 0 to 66; the lower the score, the more severe the deficit
Time frame: Baseline
Proportion of Left-Handed Participants
Time frame: Baseline
Mean National Institutes of Health Stroke Scale (NIHSS) Score
Score from 0 to 42; the higher the score, the more severe the deficit
Time frame: Baseline
Number of Participants With Upper-Limb Weakness
Number of Participants With Upper-Limb Weakness Defined as SAFE Score Less Than 10
Time frame: Baseline
Correlation Between Edinburgh Handedness Inventory Laterality Quotient and Baseline FMA-UE Score
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)
Time frame: Baseline
Mean Shoulder Abduction and Finger Extension (SAFE) Score
Score from 0 to 10; the lower the score, the more severe the deficit.
Time frame: Month 6
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