ABSTRACT
Background:
Knowledge of paretic upper limb (UL) use in the actual environment is
crucial for defining treatment strategies that are likely to enhance
performance.
Objective: To quantify the hand function and
type of grasp performed in the actual environment following stroke and
determine if any differences in hand use are dependent on the degree of
motor impairment.
Method: This cross-sectional study
enrolled 41 participants with chronic hemiparesis classified as having
either mild (11), moderate (20), or severe (10) UL impairment. A
behavioral map was used while observing hand use over the 4-h
experimental period, during which we checked: activity- unimanual, bimanual or non-task-related; hand function- stabilization, manipulation, reach-to-grasp, gesture, support or push; and type of grasp- digital or whole-hand.
Results:
Participants with severe impairment did not use the paretic UL
spontaneously; analyzing the moderate and mild subgroup together, the
predominant UL hand functions were stabilization and manipulation, the
paretic UL performs the stabilization function using the whole-hand more
frequently (71.2%) than digital (28.8%) grasp. In the subgroup
analysis, the paretic and non-paretic UL in the moderate and the paretic
UL in the mild subgroup perform the whole-hand stabilization more
frequently than digital. Digital grasp is more accomplished by the
non-paretic UL in reach-to-grasp hand function, particularly in the mild
subgroup.
Conclusion: The paretic UL is
predominantly employed for stabilization function using a whole-hand
grasp. The type of grasp in the actual environment is affected by motor
impairment, and greater motor impairment leads to the performance of
less complex tasks.
Additional information
Funding
We
received study funding from FAPESC (Fundação de Amparo à Pesquisa e
Inovação do Estado de Santa Catarina) 01/2014 - Programa Universal - nº
2015TR322. This study was not peer reviewed or invited.
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