Actual use for me is zero. It takes my good right hand a fair amount of time to force open the fingers and thumb at the same time to even attempt to grasp something. And then to remove my hand I have to jerk it off. This was useless research! Useful would be curing spasticity! GET THERE!
Hand function and type of grasp used by chronic stroke individuals in actual environment
Amanda Magalhães Demartino, Letícia Cardoso Rodrigues, Raquel Pinheiro
Gomes & Stella Maris Michaelsen
To cite this article: Amanda Magalhães Demartino, Letícia Cardoso Rodrigues, Raquel
Pinheiro Gomes & Stella Maris Michaelsen (2019): Hand function and type of grasp used
by chronic stroke individuals in actual environment, Topics in Stroke Rehabilitation, DOI:
10.1080/10749357.2019.1591037
To link to this article: https://doi.org/10.1080/10749357.2019.1591037
Amanda Magalhães Demartino
a
, Letícia Cardoso Rodrigues
a
, Raquel Pinheiro Gomes
a
and Stella Maris Michaelsen
a
a
Department of Physical Therapy, Universidade do Estado de Santa Catarina, Florianópolis, Brazil
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.
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