Patients with Duchenne and Becker muscular dystrophies are not more asymmetrical than healthy controls on timed performance of upper limb tasks.

This study aimed to investigate possible asymmetries and relationships between performance of dominant and non-dominant upper limbs (UL) in patients with Duchenne and Becker muscular dystrophies (DMD/BMD), to compare UL performance of patients and healthy subjects and to investigate the relationship between timed performance of UL and age, motor function and muscle strength in DMD/BMD patients. Sixteen patients with DMD and 3 with BMD were evaluated with Jebsen-Taylor Test (timed performance), Vignos scale and Dimension 3 of Motor Function Measure (motor function), and Medical Research Council scale (muscle strength) on a single session. ANOVA showed no asymmetry between dominant and non-dominant UL, except in the writing subtest, in patients and in healthy controls. There were relationships between dominant and non-dominant UL performances. Correlations between timed performance, motor function and muscle strength were found, but age was not correlated with these variables. These findings may reduce the assessment time, prevent fatigue and provide more accurate clinical reasoning involving UL in DMD/BMD treatment.

Estudo comparativo entre a relação do hemisfério acometido no acidente vascular encefálico e a evolução funcional em indivíduos destros / Comparative study on the relationship between stroke hemisphere and functional evolution in right-handed individuals

OBJETIVO: O hemisfério esquerdo é dominante para o controle motor e o direito para a orientação espacial. Este estudo visou testar as hipóteses de que a lesão à esquerda causa maior prejuízo da movimentação voluntária e a lesão à direita resulta em perda na atenção espacial e no controle postural. Indivíduos com lesão à esquerda foram comparados com indivíduos com lesão à direita, com relação ao comprometimento inicial e recuperação três meses pós-lesão. MATERIAIS E MÉTODOS: Vinte e dois indivíduos destros com lesão isquêmica no território da artéria cerebral média (11 à esquerda e 11 à direita) foram avaliados mensalmente nos três primeiros meses pós-lesão em termos de sensibilidade, tônus, força, postura, marcha, independência funcional e atenção espacial. RESULTADOS: Com relação ao comprometimento inicial, não houve diferença na sensibilidade, tônus, força, postura e atenção dos grupos. O grupo com lesão à esquerda apresentou pior desempenho inicial nos testes de marcha e de independência funcional. Com relação à taxa de recuperação, não houve diferenças na sensibilidade, tônus, força, postura, atenção e independência funcional dos dois grupos. Porém, a taxa de recuperação da marcha do grupo com lesão à esquerda foi inferior à do outro grupo. CONCLUSÕES: Foi confirmada a hipótese de que a lesão à esquerda causa maior comprometimento da movimentação voluntária, representada pela marcha e independência funcional, que a lesão à direita. Não foi obtida, no entanto, evidência de que a lesão à direita compromete de modo mais intenso a atenção espacial e a manutenção da postura que a lesão à esquerda.

OBJECTIVE: The left hemisphere is supposed to be dominant for motor control and the right hemisphere dominant for spatial orientation. This study aimed to test the hypothesis that left-side lesions cause greater impairment of voluntary movement, while right-side lesions cause loss of spatial attention loss and postural control. Individuals with left-side lesions were compared with individuals with right-side lesions, in relation to initial impairment and recovery three months after their stroke. METHODS: Twenty-two right-handed individuals with an ischemic lesion in the area of the middle cerebral artery (11 on the left side and 11 on the right side) were assessed monthly, for the first three months after their stroke, in terms of sensitivity, tonus, posture, gait, functional independence and spatial attention. RESULTS: In relation to the initial impairment, there was no difference in sensitivity, tonus, strength, posture and spatial attention between the groups. The left-side lesion group presented worse initial performance in gait and functional independence tests. In relation to the recovery rate, there were no differences in sensitivity, tonus, strength, posture, spatial attention or functional independence between the two groups. However, the gait recovery rate in the left-side lesion group was slower than in the other group. CONCLUSIONS: The hypothesis that left-side lesions cause greater impairment of voluntary movement (represented by gait and functional independence) than do right-side lesions was supported. However, no evidence that right-side lesions cause greater impairment of spatial attention and posture maintenance than do left-side lesions was found.