Influence of Handedness on Upper Limb Recovery

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).

Inclusion criteria

• Confirmed unilateral recent stroke (less than 5 days).
• Age 18 years and older.
• Participant or proxy does not object to participation

Exclusion criteria

• Prior stroke with residual motor sequelae.
• Pre-stroke upper-limb deficit.
• Follow-up at 6 months not planned at Orléans.
• Protected adult (guardianship/curatorship), person under legal protection, or deprived of liberty.
• Pregnant or breastfeeding woman.