Weakness Is the Primary Contributor to Finger Impairment in Chronic Stroke

Kamper, Derek G.; Fischer, Heidi; Cruz, Erik G.; Rymer, William Z.

doi:10.1016/j.apmr.2006.05.013

Cited by 180 publications

(172 citation statements)

References 40 publications

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“…Table 5 identifies various tests suitable across inpatient, outpatient, and chronic care settings to assess body structure and function motor issues after stroke; this list is not comprehensive but provides examples of more commonly used, reliable assessments (further tests can be found in Duncan et al 11 ). Regardless of care setting, strength, coordination, [75][76][77][78] and sensation (particularly joint position sense and tactile discrimination) 79 -82 should be assessed (Table 6). Although hypertonicity should be assessed, 75 a clear recommendation for its assessment is not forthcoming.…”

Section: Icf Dimensions Across the Inpatient-to-chronic Care Contmentioning

confidence: 99%

Comprehensive Overview of Nursing and Interdisciplinary Rehabilitation Care of the Stroke Patient

Miller¹,

Murray²,

Richards³

et al. 2010

Stroke

659

412

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Section: Icf Dimensions Across the Inpatient-to-chronic Care Contmentioning

confidence: 99%

Comprehensive Overview of Nursing and Interdisciplinary Rehabilitation Care of the Stroke Patient

Miller¹,

Murray²,

Richards³

et al. 2010

Stroke

659

412

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“…Here, we test our previous hypothesis, by investigating how performance on the finger extension task relates to performance on a grasping task after stroke. The first task does not require a visuomotor transformation and deficits during this task have been shown to be due to a motor execution problem (Kamper et al 2006). In contrast, on the second task, the nervous system must transform visual information about the object into motor command such that specific muscles of the arm and hand are activated at the appropriate times and to the appropriate magnitude.…”

Section: Introductionmentioning

confidence: 99%

“…The inability to extend the digits is primarily due to a limited ability to activate the finger and thumb extensor muscles (Kamper and Rymer 2001;Kamper et al 2003Kamper et al , 2006. Historically, there has been little success in improving finger and thumb extension capabilities with targeted rehabilitation techniques (Trombly et al 1986).…”

Section: Introductionmentioning

confidence: 99%

Recovery of Thumb and Finger Extension and Its Relation to Grasp Performance After Stroke

Lang¹,

DeJong²,

Beebe³

2009

Journal of Neurophysiology

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Lang CE, DeJong SL, Beebe JA. Recovery of thumb and finger extension and its relation to grasp performance after stroke. J Neurophysiol 102: 451-459, 2009. First published May 20, 2009 doi:10.1152/jn.91310.2008. This study investigated how the ability to extend the fingers and thumb recovers early after stroke and how the ability to extend all of the digits affects grasping performance. We studied 24 hemiparetic patients at 3 and 13 wk post stroke. At each visit, we tested the subjects' ability to actively extend all five digits of their contralesional, affected hand against gravity and to perform a grasp movement with the same hand. Three-dimensional motion analysis captured: 1) maximal voluntary extension excursion of each digit and 2) grasp performance variables of movement time, peak aperture, peak aperture rate, and aperture path ratio. We found that finger and thumb extension improved from 3 to 13 wk, with average improvements ranging from 12 to 19°across the five digits. Grasp performance improved on two of the four variables measured. Peak apertures and peak aperture rates improved from 3 to 13 wk, but self-selected movement time and aperture path ratio did not. Stepwise multiple regression models showed that the majority of variance in grasp performance at 13 wk could be predicted by the ability to extend the index or middle finger at 3 wk, plus the change in the ability to extend the index finger from 3 to 13 wk. R 2 values ranged from 0.55 to 0.89. Our data indicate that the amount of recovery in finger and thumb extension and grasping is small from 3 to 13 wk post stroke. In people with relatively pure motor hemiparesis, one important factor underlying deficits in hand shaping during grasping is the inability to extend the fingers and thumb. Without sufficient volitional control of finger and thumb extension, successful grasping of objects will not occur.

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“…The consequences of the somatosensory deficits include changes in the recognition and manipulation of objects, danger of burns and wounds to the limb, loss of motor control in the affected limb and difficulty in controlling the level of hand strength while reaching 12,13 . The sensory loss and loss of strength of intrinsic hand muscles are related to the involvement of upper limb movements in hemiparetics 14,15 . The expected recovery of manual control is particularly relevant because the rehabilitation strategy depends on motor recovery and the chance of developing complications secondary to paresis or spasticity 16 .…”

mentioning

confidence: 99%

Correlations between motor and sensory functions in upper limb chronic hemiparetics after stroke

Scalha¹,

Miyasaki²,

Lima³

et al. 2011

Arq. Neuro-Psiquiatr.

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Objective: Describe the somatosensory function of the affected upper limb of hemiparetic stroke patients and investigate the correlations between measurements of motor and sensory functions in tasks with and without visual deprivation. Method: We applied the Fugl-Meyer Assessment (FMA), Nottingham Sensory Assessment (NSA), and several motor and sensory tests: Paper manipulation (PM), Motor Sequences (MS), Reaching and grasping (RG) Tests Functional (TF), Tactile Discrimination (TD), Weight Discrimination (WD) and Tactile Recognition of Objects (RO). Results: We found moderate correlations between the FMA motor subscale and the tactile sensation score of the NSA. Additionally, the FMA sensitivity was correlated with the NSA total; and performance on the WD test items correlated with the NSA. Conclusion: There was a correlation between the sensory and motor functions of the upper limb in chronic hemiparetic stroke patients. Additionally, there was a greater reliance on visual information to compensate for lost sensory-motor skills.

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Weakness Is the Primary Contributor to Finger Impairment in Chronic Stroke

Cited by 180 publications

References 40 publications

Comprehensive Overview of Nursing and Interdisciplinary Rehabilitation Care of the Stroke Patient

Comprehensive Overview of Nursing and Interdisciplinary Rehabilitation Care of the Stroke Patient

Recovery of Thumb and Finger Extension and Its Relation to Grasp Performance After Stroke

Correlations between motor and sensory functions in upper limb chronic hemiparetics after stroke

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