İNME SONRASI İPSİLEZYONEL ÜST EKSTREMİTEDE GÖRÜLEN FONKSİYONEL ETKİLENİMİN KİNEMATİK İNCELENMESİ

Abstract

Demirkol A. Kinematic investigation of functional impairment in the ipsilesional upper extremity after stroke. Hacettepe University Graduate School of Health Sciences Neurology Physiotherapist Master Thesis, Ankara, 2026. The aim of this study was to investigate the functional impairment in the ipsilesional upper extremity in individuals with chronic stroke through kinematic analysis and to assess the relationship between this impairment and hemispheric characteristics. The study included 25 individuals with chronic stroke, with a median age of 65.00 (55.00–75.00) years, and 24 healthy individuals, with a median age of 65.00 (53.75–71.25) years. Kinematic analysis of ipsilesional upper extremity movements was performed using Xsens Awinda (XSens Technologies B.V., Enschede, Netherlands) inertial measurement unit (IMU) sensors during ball transfer and string-passing tasks. Movement duration, peak velocity, normalised jerk, total path length, trunk contribution and joint ranges of motion were analysed. In individuals with stroke, both the ball transfer and string-passing tasks revealed that the movement duration of the ipsilesional upper extremity was longer and peak velocity values were lower (p<0.05). Normalised jerk values, which reflect movement fluency, were found to be significantly higher, particularly in the ball transfer task (p<0.05). According to the results of the trajectory analysis, the reach distance was found to be statistically shorter in individuals with stroke compared to healthy individuals (p<0.05). According to the results of the trajectory analysis, the reach distance was found to be statistically shorter in individuals with spasticity compared to healthy individuals (p<0.05). In the rope-passing task, the total path length was found to be significantly shorter in the stroke group (p<0.05). In the top transfer and rope-passing tasks, the T8 maximum excursion and the range of motion values of T8 along the X and Y axes were found to be lower in individuals with stroke than in healthy individuals (p<0.05). Additionally, the trunk-to-hand ratio and normalised T8 maximum excursion were significantly lower in the hemiplegic group (p<0.001). In joint range of motion analyses, changes were observed in elbow range of motion, whilst differences were also noted between groups in trunk usage patterns (p<0.05). In exploratory analyses based on lesion side, higher normalised jerk values were observed in individuals with right hemisphere lesions, particularly during the string-passing task (p<0.05). In conclusion, it was determined that the ipsilesional upper extremity is not a completely intact neuromotor structure; it may exhibit alterations in characteristics related to movement fluency, timing, trajectory control and coordination. Furthermore, it was observed that this effect may vary depending on the motor demands of the task and becomes more pronounced, particularly in more complex tasks. These findings indicate that the ipsilesional upper extremity should not be overlooked in post-stroke assessment and rehabilitation processes, and that kinematic analyses can make significant contributions to clinical evaluations.