Deans' stroke musings: A new hand assessment instrument for severely affected stroke patients

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Wednesday, March 26, 2025

A new hand assessment instrument for severely affected stroke patients

I don't see how 'assessments' do one damn thing for survivor recovery! You've documented the problem but haven't solved how to recover!

A new hand assessment instrument for severely affected stroke patients

Doris Broetz a,∗ , Nicholas A. Del Grosso a , Massimiliano Rea a , Ander Ramos-Murguialday a,b , Surjo R. Soekadar a,c and Niels Birbaumer a,d a Institute of Medical Psychology and Behavioral Neurobiology, MEG Center, University of Tuebingen, Tuebingen, Germany b Health Technologies Department, TECNALIA, San Sebastian, Spain c Department of Psychiatry and Psychotherapy, University of Tuebingen, Tuebingen, Germany d Ospedale San Camillo, Istituto di Ricovero e Cura a Curattere Scientiﬁco, IRCCS, Venezia, Italy

Abstract.

BACKGROUND:

Standard assessment instruments cannot differentiate patients with minimal residual hand function after stroke. As a result, changes in motor recovery are difﬁcult to document using currently-available tests. In a controlled study with chronic stroke patients without residual ﬁnger extension, a new hand function test has been developed. This instrument, called Broetz Hand Test (BzH), allows to assess small variations in hand function in severely paralyzed stoke patients. The instrument is easy to use, and was developed using principles of motor learning and behavioral assessment.

METHODS:

The instrument consists of seven daily life-oriented tasks, each of which asks for movement of the paralyzed hand. BzH of 20 patients after stroke was evaluated before and after a behavioral physiotherapy treatment. Sensitivity, inter-observer reliability, test-retest reliability and construct validity was calculated.

RESULTS:

Two-tailed paired-samples t-test before and after treatment demonstrated sufﬁcient sensitivity. Mean agreement between the raters resulted in an excellent interrater-reliability. Test-retest reliability between the pre- and post-treatment scores was 0.9. The correlation between BzH and standard test scores was statistically signiﬁcant and demonstrated sufﬁcient validity.

CONCLUSION:

The BzH is a valid and reliable tool to assess changes in hand function in severely paralyzed patients after stroke. But useless for recovery!