Arm function after stroke - AI generated

 AI is almost completely worthless until the underlying research for 100% recovery is there! 

They should be able to point directly to the research underlying their recommendations and the efficacy of them.  But they won't know a damn thing other than a black box spit something out. All you're going to get is worthless guidelines, NOT ANYTHING SPECIFIC AT ALL!

Arm function after stroke - AI generated

ALAN SUNDERLAND, DEBORAH TINSON, LESLEY BRADLEY, RICHARD LANGTON HEWER From the Stroke/Neurological Rehabilitation Unit, Frenchay Hospital, Bristol, UK SUMMARY 

The value of strength of voluntary grip as an indicator of recovery of arm function was assessed by testing 38 recent stroke patients using a sensitive electronic dynamometer, and comparing the results with those from five other arm movement and function tests (Motricity Index, Motor Club Assessment, Nine Hole Peg Test, and Frenchay Arm Test). This procedure allowed measurement of grip in a large proportion of patients, and strength correlated highly with performance on the other tests. Measuring grip over a six month follow up period was a sensitive method of charting intrinsic neurological recovery. The presence of voluntary grip at one month indicates that there will be some functional recovery at six months. Progress in understanding recovery from stroke and assessing the impact of rehabilitation therapy has been limited by the lack of good measures of function. In this context a good measure is one which is reliable, valid and sufficiently sensitive to detect small changes in performance. Also, it should have a wide range of use capable of measuring mild as well as severe impairment. The ideal measure would meet these requirements yet only require a brief and simple assessment procedure. This would allow frequent monitoring to chart the course of recovery. In a previous study,' the available tests of arm function after stroke were reviewed. Four tests were assessed against the above criteria and these were the Frenchay Arm Test,2 the Nine Hole Peg Test,3 speed of finger tapping,4 and measurement of strength of grip. All four were found to be reliable and valid but they varied in their range of use and sensitivity to change. Of particular interest were the results for strength of the grip which showed that it was the best of these measures for detecting early recovery and was useful in predicting the final outcome. These results emerged despite the fact that a mechanical dynamometer was used which had limited sensitivity at the upper and Correspondence to: Dr Sunderland, Stroke/Neurological Rehabilitation Unit, Frenchay Hospital, Bristol BS 16 ILE, UK. Received 13 January 1989 and in revised form 29 March 1989. Accepted 6 April 1989 lower ends of the range of strength of grip. This paper reports the data collected using an electronic dynamometer with a much wider range of sensitivity. We aimed to investigate to what extent strength of grip meets the criteria of a good measure of recovery of arm function when measured with such an instrument. Measuring the grip strength of stroke patients has not been widely used as an assessment procedure and indeed has been rejected actively as a method within orthodox physiotherapy.56 This rejection has been motivated by two concerns. First, that measuring strength alone ignores the role of impaired co-ordina- tion of muscle groups in producing deficient motor performance. Second, it has been argued that because an increase in finger flexion is part of the spastic pattern which typically evolves after stroke,7 8 increased grip might indicate this spasticity rather than any improvement in muscle control. On the other hand there is ample evidence to show that weakness is one of the primary components of hemiplegia9 "' which improves with functional recovery.' This study investigated the relationship between grip strength, spasticity and functional recovery to discover whether in fact it may be a valuable marker of recovery in the typical stroke patient.

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