Perceived ability to perform daily hand activities after stroke and associated factors: a cross-sectional study

Abstract

BackgroundDespite that disability of the upper extremity is common after stroke, there is limited knowledge how it influences self-perceived ability to perform daily hand activities. The aim of this study was to describe which daily hand activities that persons with mild to moderate impairments of the upper extremity after stroke perceive difficult to perform and to evaluate how several potential factors are associated with the self-perceived performance.MethodsSeventy-five persons (72 % male) with mild to moderate impairments of the upper extremity after stroke (4 to 116 months) participated. Self-perceived ability to perform daily hand activities was rated with the ABILHAND Questionnaire. The perceived ability to perform daily hand activities and the potentially associated factors (age, gender, social and vocational situation, affected hand, upper extremity pain, spasticity, grip strength, somatosensation of the hand, manual dexterity, perceived participation and life satisfaction) were evaluated by linear regression models.ResultsThe activities that were perceived difficult or impossible for a majority of the participants were bimanual tasks that required fine manual dexterity of the more affected hand. The factor that had the strongest association with perceived ability to perform daily hand activities was dexterity (p < 0.001), which together with perceived participation (p = 0.002) explained 48 % of the variance in the final multivariate model.ConclusionPersons with mild to moderate impairments of the upper extremity after stroke perceive that bimanual activities requiring fine manual dexterity are the most difficult to perform. Dexterity and perceived participation are factors specifically important to consider in the rehabilitation of the upper extremity after stroke in order to improve the ability to use the hands in daily life.

Sensory Function, Measured as Active Discriminative Touch, is Associated With Dexterity after Stroke

“…A central factor in the ability to perform daily activities is dexterity of the hand . Dexterity is defined as the ability to grip and release an object, perform precision grips, coordinate finger movements, and manipulate objects .…”

“…Dexterity is defined as the ability to grip and release an object, perform precision grips, coordinate finger movements, and manipulate objects . It has been shown that dexterity can predict poststroke UL recovery, and is an important factor in the long‐term use of the affected hand in daily life . Previous studies have shown that single factors such as sensory impairment, muscle strength, and spasticity are associated with dexterity after stroke .…”

“…7 A central factor in the ability to perform daily activities is dexterity of the hand. 8 Dexterity is defined as the ability to grip and release an object, perform precision grips, coordinate finger movements, and manipulate objects. 9 It has been shown that dexterity can predict poststroke UL recovery, 10,11 and is an important factor in the long-term use of the affected hand in daily life.…”

“…9 It has been shown that dexterity can predict poststroke UL recovery, 10,11 and is an important factor in the long-term use of the affected hand in daily life. 8 Previous studies have shown that single factors such as sensory impairment, muscle strength, and spasticity are associated with dexterity after stroke. [12][13][14][15][16][17] However, because several factors may influence dexterity simultaneously, there is a need to understand how these factors are associated with the performance.…”

Issues in rehabilitation of patients after stroke in the out-patient setting

“…Результаты ряда исследований, проведенных Welmer et al [43][44][45], свидетельствуют о худшем восстановлении двигательных функций верхней конечности в сравнении с нижней. Для улучшения функционирования верхней конечности необходимо увеличение продолжительности Ключевые принципы постинсультной реабилитации включают функциональный подход, частые и интенсивные тренировки, ориентированные на конкретные задачи, и раннее их начало (в первые дни или недели после инсульта) и частоты повторений направленных движений.…”