Article

The objectives of this study are to establish frequency, clinical
correlates and predictors of upper limb dexterity in patients who have survived 1
year or more after a stroke. DESIGN: Cross-sectional study. SETTING: Outpatient
clinic of a tertiary rehabilitation centre. PARTICIPANTS: One hundred and forty
patients who were more than a year after stroke onset. INTERVENTIONS: Nil. MAIN
OUTCOME MEASURES: Motor Assessment Scale (MAS) for measurement of upper limb
dexterity, Ashworth Scale for spasticity, Upper Extremity Motricity Index (UEMI)
and Lower Extremity Motricity Index (LEMI) for motor power and Modified Barthel
Index (MBI) for functional status. Spasticity was categorized as absent to
moderate and severe. Potential predictors of dextrous function were chosen based
on retrospective review of the patient's medical records during admission for
inpatient rehabilitation. RESULTS: The mean age was 61.0 +/- 13.3 years and
patients were evaluated at 41.7 +/- 35.1 months after stroke onset. Upper limb
dexterity was present in 40 (28.3% patients. Sensory impairment, severe
spasticity and low scores on the MBI, UEMI and LEMI were significantly correlated
to poor dextrous function, with severe spasticity (p < 0.001) and UEMI score (p =
0.025) being the most important. Poor dextrous function was predicted by a severe
stroke, neglect, sensory impairment, total/partial anterior circulation stroke
and low MBI, UEMI and LEMI scores on rehabilitation admission. The most important
predictor of dexterity was UEMI score on admission to rehabilitation (p=0.005).
CONCLUSION: Upper limb dexterity was present in 28.3% of a cohort of chronic
stroke patients. The most important correlates of limb dexterity were upper limb
strength and severe spasticity and the most significant predictor of dexterity
was the severity of upper limb paresis on admission to rehabilitation.

Langue : ANGLAIS