Abstract
Objective
To investigate the performance of the less affected upper limb in people with stroke
compared with normative values. To examine less affected upper limb function in those
whose prestroke dominant limb became paretic and those whose prestroke nondominant
limb became paretic.
Design
Cohort study of survivors of chronic stroke (7.2±6.7y post incident).
Setting
The study was performed at a freestanding academic rehabilitation hospital.
Participants
Survivors of chronic stroke (N=40) with severe hand impairment (Chedoke-McMaster Stroke
Assessment rating of 2-3 on Stage of Hand) participated in the study. In 20 participants
the prestroke dominant hand (DH) was tested (nondominant hand [NH] affected by stroke),
and in 20 participants the prestroke NH was tested (DH affected by stroke).
Interventions
Not applicable.
Main Outcome Measure
Jebsen-Taylor Hand Function Test. Data from survivors of stroke were compared with
normative age- and sex-matched data from neurologically intact individuals.
Results
When combined, DH and NH groups performed significantly worse on fine motor tasks
with their nonparetic hand relative to normative data (P<.007 for all measures). Even the participants who continued to use their prestroke
DH as their primary hand after the stroke demonstrated reduced fine motor skills compared
with normative data. In contrast, grip strength was not significantly affected in
either group of survivors of stroke (P>.140).
Conclusions
Survivors of stroke with severe impairment of the paretic limb continue to present
significant upper extremity impairment in their nominally nonparetic limb even years
after stroke. This phenomenon was observed regardless of whether the DH or NH hand
was primarily affected. Because this group of survivors of stroke is especially dependent
on the nonparetic limb for performing functional tasks, our results suggest that the
nonparetic upper limb should be targeted for rehabilitation.
Keywords
List of abbreviations:
BBT (box and blocks test), DH (dominant hand), FMUE (Fugl-Meyer Assessment of the Upper Extremity), GS (grip strength), JTHFT (Jebsen-Taylor Hand Function Test), LPS (lateral pinch strength), NH (nondominant hand), 9HPT (9-hole peg test), PPS (palmar pinch strength)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: February 27, 2020
Footnotes
Supported by the National Institutes of Health (grant no. NIH 5R01HD075813-05).
Clinical Trial Registration No.: NCT02418949.
Disclosures: none.
Identification
Copyright
© 2020 by the American Congress of Rehabilitation Medicine
