Study of Compensatory Strategies for Reach-to-Grasp-Pen in Stroke Patients

Abstract

Background: In patients with post-stroke hemiplegia, coordinated reaching and grasping movements may be impaired. Patients frequently adopt compensatory strategies, which require investigation.Objectives: This study examined compensatory strategies using kinematic parameters by assessing the reach-to-grasp-pen movements in stroke patients and unaffected participants – and whether such assessment distinguished between patients with different levels of stroke, and none.Methods: Twelve stroke patients with mild impairment, 12 with moderate impairment and 10 healthy individuals performed a reach-to-grasp-pen task. Results: Stroke patients showed longer reaching movement time, less smooth movement trajectories and more trunk rotation (P ＜ 0.05). In stroke patients, the MCP and PIP of the thumb were flexed in the starting position; the MCP and PIP joints of the index finger in the stroke group were more extended during pen grasp; the range of motion of the MCP of the middle finger and of the PIP joints of the middle, ring and little fingers became greater, suggesting a larger peak aperture (P ＜ 0.05). Greater extension was observed in the index finger at the end of the grasp, suggesting inadequate flexion (P ＜ 0.05).Conclusions: The reach-to-grasp-pen task can identify patients according to stroke level and shows potential as an assessment tool.