Kinematic improvements in upper extremity recovery post-stroke may be driven by dominant hand impairment, possibly reflecting motor control differences or greater reliance on the dominant hand, highlighting the need for targeted rehabilitation strategies tailored to the non-dominant hand's functional role.
Key Findings
Results
Clinical measures improved significantly within 45 days post-stroke in both dominant and non-dominant hand affected groups.
Twenty participants post-stroke were assessed five times over six months, with initial testing around 15 days post-stroke (mean = 14.9 days).
Ten participants had their dominant hand affected and ten had their non-dominant hand affected.
Clinical assessments showed significant improvements in both groups within the 45-day post-stroke window.
Piecewise linear mixed-effects models were used to evaluate longitudinal trends.
Results
Most kinematic measures improved significantly in the first 30 days post-stroke but plateaued thereafter.
Kinematic measurements included Time to Peak Velocity, Time After Peak Velocity, Reach Duration, Reaching Trajectory Smoothness, Path Linearity, and Grasp Duration.
Tasks involved reach-to-grasp-and-lift of a 1-inch cube and a 2.5-inch circular object.
The plateau in kinematic recovery occurred after approximately 30 days post-stroke.
This pattern contrasts with clinical measures, which continued to show significant improvement through 45 days post-stroke.
Results
Significant kinematic improvements were demonstrated only in the group with the dominant hand affected, not in the non-dominant hand affected group.
A secondary exploratory analysis examined the effects of hand dominance on upper extremity recovery.
Both groups showed significant clinical improvements over time.
Kinematic improvements were statistically significant only in the dominant hand affected group.
The non-dominant hand affected group did not demonstrate significant kinematic improvements despite showing clinical gains.
This difference suggests that kinematic improvements may be driven by dominant hand impairment.
Discussion
The divergence between clinical and kinematic recovery outcomes suggests that standard clinical measures may not fully capture motor recovery differences related to hand dominance.
Both groups improved on clinical assessments, yet only the dominant hand group showed kinematic gains.
This dissociation implies clinical scales may lack the sensitivity to detect dominance-related differences in motor control recovery.
Kinematic measures provided additional granularity beyond what clinical assessments captured.
The authors note this highlights the value of kinematic assessment in longitudinal stroke recovery research.
Discussion
Differences in recovery trajectories between dominant and non-dominant hand affected groups may reflect motor control differences or greater reliance on the dominant hand.
The authors propose that the dominant hand may have a different neuromotor representation that facilitates kinematic recovery.
Greater daily reliance on the dominant hand is suggested as a possible contributing factor to observed recovery differences.
The pilot study design with ten participants per group limits generalizability and the authors describe the dominance analysis as exploratory.
Findings are described as suggesting a need for targeted rehabilitation strategies tailored to the non-dominant hand's functional role.
Methods
This was a pilot longitudinal study with a small sample of twenty post-stroke participants assessed across five time points over six months.
Participants were divided equally into dominant hand affected (n=10) and non-dominant hand affected (n=10) groups.
Initial testing occurred at a mean of 14.9 days post-stroke.
Five assessments were conducted over the six-month follow-up period.
The authors characterize the dominance-related analysis as secondary and exploratory, acknowledging the limited sample size.
What This Means
This research suggests that whether a stroke affects a person's dominant or non-dominant hand matters for how motor skills recover over time. In a six-month study tracking 20 stroke survivors (half with their dominant hand affected, half with their non-dominant hand affected), researchers found that standard clinical assessments improved in both groups within about 45 days. However, more detailed movement measurements — capturing things like how smoothly and directly participants could reach and grasp objects — only showed significant improvement in people whose dominant hand was affected. People with their non-dominant hand affected showed clinical gains but not meaningful kinematic gains.
This research suggests that the two groups may recover differently at a movement quality level, even when standard clinical tests suggest similar improvement. The dominant hand, being more heavily used in daily life and potentially having stronger brain representation, may be better positioned to recover refined movement patterns after stroke. The non-dominant hand's recovery may follow a different path that current rehabilitation approaches may not adequately address.
The practical implication is that rehabilitation programs may need to be tailored differently depending on which hand is affected by stroke. Because this was a small pilot study with only ten participants per group, the findings are preliminary and exploratory, but they point to the importance of using detailed movement analysis alongside standard clinical tools to better understand and guide stroke recovery.
Gutterman J, Fluet G, Qiu Q, Patel J, Gorin H, Karunakaran K, et al.. (2026). Hand Dominance Influences Motor Recovery Trajectories Following Stroke: A Longitudinal Study.. Sensors (Basel, Switzerland). https://doi.org/10.3390/s26175599