Motor Coordination and Grip Strength of the Dominant and Non-Dominant Affected Upper Limb Depending on the Body Position—An Observational Study of Patients after Ischemic Stroke (original) (raw)
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Brain Sciences
Almost half of the patients surveyed report impaired function of the upper limbx and handx after stroke. The effect of the passive trunk and shoulder stabilization on the recovery of coordinated hand movement is unclear. This study examined whether passive stabilization of the trunk and shoulder could improve the functional state of the hands after various types of strokes. It is an observational prospective cohort study conducted at the Rehabilitation Clinic in two parallel groups of patients with four different types of strokes (hemorrhagic and ischemic of the brain, similar to the cerebellum). A total of 120 patients were analyzed. Patients were examined in various positions: sitting without a backrest with the upper limb adjacent to the body, supine with the upper limb perpendicular to the body, and supine with the arm stabilized in relation to the patient’s body. Hand Tutor devices and a hand dynamometer were used for the measurements. The frequency and maximum range of motion ...
Iranian Rehabilitation Journal, 2023
Objectives: This study aims to investigate the impact of impaired upper limb motor function on trunk control and mobility in chronic post-stroke survivors so that the upper limb function should be enhanced as a core component of rehabilitation. Methods: This analytical cross-sectional study was conducted from March 2021 to August 2021 at the Rehabilitation Center for the Physically Disabled in Peshawar, Pakistan. A total of 166 chronic stroke patients in the age range of 35 to 70 years and greater than 6 months post-stroke were included. To assess the impaired upper extremity, the Fugl-Meyer assessment upper extremity scale was used, and the trunk control and mobility were checked through functional reach test and timed up and go test, respectively. Results: Among 166 stroke survivors having upper extremity impairment, 109(65.7%) participants’ upper extremity was severely affected. Mobility levels measured through the timed up and go test were categorized and scored; accordingly, the participants showed a low risk of 22(13.3%), moderate 32(19.3%), high 72(43.4%), and very high risk of falls of 40(24%). Among 166 patients, 147(88.6%) had no trunk control which resulted in 8 times greater fall risk in 65(39.2%) participants. Thus, upper limb impairment is significantly associated with impaired trunk control and mobility (P=0.001). Discussion: This study found about one-third of stroke survivors have a risk of falling, two-thirds have upper extremity impairment, and two-thirds have no trunk control. This study showed a significant reduction in mobility level, balance, and posture balance in stroke survivors having upper extremity impairment. These findings suggest that stroke survivors with upper extremity impairment may use therapeutic intervention to minimize falls and enhance postural balance and trunk control.
International Journal of Environmental Research and Public Health
Objective: The stroke is considered a common disease of the elderly. Young people also get sick, but the risk of stroke increases with the age of 60. Stroke, regardless of the age of the patients, causes functional deficits; therefore, the aim of the study was to analyze the significance of the body position and examined upper limb on the parameters of motor coordination and handgrip strength in various age groups of people after stroke and healthy people. Material and method: This is an observational study. A total of 117 people participated in the study (60 stroke patients and 57 healthy people without neurological disorders). Both patients and healthy volunteers were prospectively divided into three age groups: 18–45, 46–60, and 61+. The tests were carried out in two starting positions: sitting without back support and lying on the back with the upper limb stabilized against the body. HandTutorTM and a hand dynamometer were used to assess the motor coordination, including the max...
Deficits in upper limbs after stroke
Revista Neurociências, 2015
Objective. To verify whether the functional hemispheric asymmetries exert influence over the deficits on upper limbs of hemiparetic stroke patients. Method. 42 right-handed patients participated in the study, 18 women and 24 men, average age 61.7±10 years, average time lesion 22±15.1 months. The instruments of measurements: Handgrip Dynamometer, Esthesiometer, Box and Blocks Test, Nine Hole and Peg Test, Barthel Index, Movements Hand Scale and the Modified Ashworth Scale. Results. All tests showed a difference between the paretic and non-paretic sides. Between men and women there was a difference only in the handgrip (p=0.001 paretic side and p<0.000 non paretic side). As hemispheric dominance was different in the paretic limb, with the best performance in Box and Blocks Test on the dominant side (p=0.016). Conclusion: In hemiparetic patients the contralateral alterations are global and more severe, and the ipsilateral are related to the manual dexterity. The evaluation and the...
Applied Sciences, 2022
In the acute phase of stroke, most patients have reduced efficiency of the upper limb and in the chronic phase more than half of these patients still have a deficit in the mobility of the upper limb. The aim of this study was to investigate the effect of using the tipstim® device and the tested position of the body and affected upper limb on parameters of motor coordination and grip strength in patients after an ischemic stroke. A randomized, parallel crossover study was conducted in the Rehabilitation Department. The study included 29 people aged 68 ± 9.2 years, 5–7 weeks after ischemic stroke. Patients were randomly assigned to two parallel groups (A/B = 15 people and B/A = 14 people). In each of them, the patient received both experimental (A = tipstim®) and control (B = placebo effect) treatment in a specific order. The HandTutor was used to measure the parameters of motor coordination (maximum range of motion and frequency of motion). We also used an electronic dynamometer to m...
International Journal of Science and Healthcare Research, 2021
Background: Stroke often leads to significant impairment of trunk and upper extremity functions, which is associated with decreased quality of life and functional performance in all domains. Trunk stability and control is considered to be a prerequisite for upper extremity function in stroke survivors. Therefore, it is important to evaluate the relationship between trunk impairment and upper extremity function in stroke survivors which may help in improving their ADL’s by giving proper treatment. Methods: 20 chronic stroke survivors with age group between 40 – 80 years were included in this study. Trunk impairment, upper extremity function and activities of daily living of all the participants were determined using trunk impairment scale, Chedoke arm and hand activity inventory scale (version 8) and functional independence measure – motor scoring scale. Results: Using Karl Pearson’s Correlation coefficient, moderate positive correlation was observed between TIS and CAHAI-8. Strong p...
The nature of the loss of strength and dexterity in the upper limb following stroke
Human Movement Science, 1996
People who had suffered a stroke within the previous two years were tested for strength, dexterity and the ability to generate fast movements of their affected elbow and compared to age-matched controls. Strength was measured via the joint torque generated during a maximal isometric contraction of the elbow flexors and extensors. Dexterity was assessed separately from strength by a tracking task that required skilled interaction of elbow joint flexors and extensors at two speeds -slow and fast. This task was set up so that very little strength was required to perform the task. Additionally, the ability to generate fast movements was measured by requiring subjects to flex and extend their elbow as fast as they could. Performance of the tracking task deteriorated at the faster speed in all subjects, however, this effect was more pronounced following stroke. In the stroke subjects, strength was poorly correlated with dexterity. Generally, stroke subjects could and did move their elbows in flexion and extension faster than was required to follow the targets. Poor performance of the stroke subjects on the tracking task was, therefore, the result of poor muscle control -a separate entity from strength. The results of this study indicate that weakness and loss of dexterity following stroke are separate problems, both of which may contribute to the slowness of movement seen in the clinic. Fax: + 6 I 2 935 l-9278, Tel.: i 61 2 935 I-9534. 0167-9457/96/$15.00 Copyright 0 1996 Elsevier Science B.V. All rights reserved. PJJ SO167-9457(96)000 15-2 L. Ada et al./ Human Movement Science 15 (1996) 671-687
Effect of Weighted Hand Movements on Hand Function in Chronic Stroke Patients
International Journal of Physiotherapy and Research, 2017
Background: Hand dysfunction is a common problem of stroke patients and it is the main cause of impairment of the upper limb. Finding new method to improve hand performance will decrease the disability of chronic stroke patients. Aim of the study: to study the effect of bilateral hand training with weight on the non paretic hand on the hand performance and time of performance in chronic stroke patients. Materials and Methods: Thirty left chronic stroke patients participated in this study. The patients were assigned randomly into two equal groups. Group one (G1) received unilateral hand training and group two (G2) received bilateral hand training with weight on non affected hand. Both groups assessed two times before starting training program and after two months of training by Fugl meyer assessment scale, Wolf motor function test and hand dynamometer for the motor performance, time of performance and hand grip respectively. Results: the patients in G2 showed significant improvement in the hand performance (P<.0001) and significant decrease in the time of performance (P<.001) and also significant improvement of hand grip (P<.0001). Conclusion: Bilateral hand movement with weight on the non affected hand has a significant effect on improving hand performance and decreasing the time of performance and increasing hand grip than unilateral hand movement.
Effect of Physiotherapy on Hand Rehabilitation in Acute Ischemic Stroke Survivor: A Case Report
Journal of Pharmaceutical Research International, 2022
Background: Ischemic injury to the brain caused by a sudden drop in blood supply causes over 80% of strokes. Large artery blockage occurs in about 25-35 percent of strokes, and patients in this category often have severe neurological impairments. The prognosis is bleak if treatment is not started right away. Imaging of the brain after a stroke is crucial for determining the extent of tissue damage and guiding treatment. Aim: To determine the effect of early hand rehabilitation post ischemic stroke. Presentation of Case: A 35-year-old woman with a history of hypertension acquired aphasia, left hemiplegia, and hemisensory loss all at the same time. She was sent to the hospital's emergency room. On CT the blockage of the right middle cerebral artery revealed an acute ischemic stroke. The Motor Assessment Scale is taken in which there is a hand function domain also to assess it. Discussion: There are many studies on hand rehabilitation, but usually we stated hand rehabilitation late...