Variation in the rate of recovery in motor function between the upper and lower limbs in patients with stroke: some proposed hypotheses and their implications for research and practice

BackgroundStroke results in impairment of motor function of both the upper and lower limbs. However, although it is debatable, motor function of the lower limb is believed to recover faster than that of the upper limb. The aim of this paper is to propose some hypotheses to explain the reasons for th...

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Main Authors: Auwal Abdullahi, Thomson W. L. Wong, Shamay S. M. Ng
Format: Article
Language:English
Published: Frontiers Media S.A. 2023-08-01
Series:Frontiers in Neurology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fneur.2023.1225924/full
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author Auwal Abdullahi
Thomson W. L. Wong
Shamay S. M. Ng
author_facet Auwal Abdullahi
Thomson W. L. Wong
Shamay S. M. Ng
author_sort Auwal Abdullahi
collection DOAJ
description BackgroundStroke results in impairment of motor function of both the upper and lower limbs. However, although it is debatable, motor function of the lower limb is believed to recover faster than that of the upper limb. The aim of this paper is to propose some hypotheses to explain the reasons for that, and discuss their implications for research and practice.MethodWe searched PubMED, Web of Science, Scopus, Embase and CENTRAL using the key words, stroke, cerebrovascular accident, upper extremity, lower extremity, and motor recovery for relevant literature.ResultThe search generated a total of 2,551 hits. However, out of this number, 51 duplicates were removed. Following review of the relevant literature, we proposed four hypotheses: natural instinct for walking hypothesis, bipedal locomotion hypothesis, central pattern generators (CPGs) hypothesis and role of spasticity hypothesis on the subject matter.ConclusionWe opine that, what may eventually account for the difference, is the frequency of use of the affected limb or intensity of the rehabilitation intervention. This is because, from the above hypotheses, the lower limb seems to be used more frequently. When limbs are used frequently, this will result in use-dependent plasticity and eventual recovery. Thus, rehabilitation techniques that involve high repetitive tasks practice such as robotic rehabilitation, Wii gaming and constraint induced movement therapy should be used during upper limb rehabilitation.
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spelling doaj.art-a1f8c5f1f7424790bf1bd0914e40c9f92023-08-03T14:13:24ZengFrontiers Media S.A.Frontiers in Neurology1664-22952023-08-011410.3389/fneur.2023.12259241225924Variation in the rate of recovery in motor function between the upper and lower limbs in patients with stroke: some proposed hypotheses and their implications for research and practiceAuwal AbdullahiThomson W. L. WongShamay S. M. NgBackgroundStroke results in impairment of motor function of both the upper and lower limbs. However, although it is debatable, motor function of the lower limb is believed to recover faster than that of the upper limb. The aim of this paper is to propose some hypotheses to explain the reasons for that, and discuss their implications for research and practice.MethodWe searched PubMED, Web of Science, Scopus, Embase and CENTRAL using the key words, stroke, cerebrovascular accident, upper extremity, lower extremity, and motor recovery for relevant literature.ResultThe search generated a total of 2,551 hits. However, out of this number, 51 duplicates were removed. Following review of the relevant literature, we proposed four hypotheses: natural instinct for walking hypothesis, bipedal locomotion hypothesis, central pattern generators (CPGs) hypothesis and role of spasticity hypothesis on the subject matter.ConclusionWe opine that, what may eventually account for the difference, is the frequency of use of the affected limb or intensity of the rehabilitation intervention. This is because, from the above hypotheses, the lower limb seems to be used more frequently. When limbs are used frequently, this will result in use-dependent plasticity and eventual recovery. Thus, rehabilitation techniques that involve high repetitive tasks practice such as robotic rehabilitation, Wii gaming and constraint induced movement therapy should be used during upper limb rehabilitation.https://www.frontiersin.org/articles/10.3389/fneur.2023.1225924/fullstrokeupper extremitylower extremitymotor recoverynatural instinct for walking hypothesisbipedal locomotion hypothesis
spellingShingle Auwal Abdullahi
Thomson W. L. Wong
Shamay S. M. Ng
Variation in the rate of recovery in motor function between the upper and lower limbs in patients with stroke: some proposed hypotheses and their implications for research and practice
Frontiers in Neurology
stroke
upper extremity
lower extremity
motor recovery
natural instinct for walking hypothesis
bipedal locomotion hypothesis
title Variation in the rate of recovery in motor function between the upper and lower limbs in patients with stroke: some proposed hypotheses and their implications for research and practice
title_full Variation in the rate of recovery in motor function between the upper and lower limbs in patients with stroke: some proposed hypotheses and their implications for research and practice
title_fullStr Variation in the rate of recovery in motor function between the upper and lower limbs in patients with stroke: some proposed hypotheses and their implications for research and practice
title_full_unstemmed Variation in the rate of recovery in motor function between the upper and lower limbs in patients with stroke: some proposed hypotheses and their implications for research and practice
title_short Variation in the rate of recovery in motor function between the upper and lower limbs in patients with stroke: some proposed hypotheses and their implications for research and practice
title_sort variation in the rate of recovery in motor function between the upper and lower limbs in patients with stroke some proposed hypotheses and their implications for research and practice
topic stroke
upper extremity
lower extremity
motor recovery
natural instinct for walking hypothesis
bipedal locomotion hypothesis
url https://www.frontiersin.org/articles/10.3389/fneur.2023.1225924/full
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