Article

The presence of subtle losses in hand dexterity after stroke affects
the regaining of independence with regard to activities of daily living.
Therefore, awareness of ipsilesional upper extremity (UE) function may be of
importance when developing a comprehensive rehabilitation program. However,
current hand function tests seem to be unable to identify asymptomatic UE
impairments. OBJECTIVES: To assess the motor coordination as well as the sensory
perception of an ipsilesional UE using biomechanical analysis of
performance-oriented tasks and conducting a Manual Tactile Test (MTT). DESIGN:
Case-controlled study. SETTING: A university hospital. PARTICIPANTS: A total of
21 patients with unilateral stroke, along with 21 matched healthy control
subjects, were recruited. METHODS: Each participant was requested to perform a
pinch-holding-up activity (PHUA) test, object-transport task, and reach-to-grasp
task via motion capture, as well as the MTT. MAIN OUTCOME MEASUREMENTS: The
kinetic data of the PHUA test, kinematics analysis of functional movements, and
time requirement of MTT were analyzed. RESULTS: Patients with ipsilesional UE had
an inferior ability to scale and produce pinch force precisely when conducting
the PHUA test compared to the healthy controls (P < .05). The movement time was
statistically longer and peak velocity was significantly lower (P < .05) in the
performance-oriented tasks for the ipsilesional UE patients. The longer time
requirement in 3 MTT subtests showed that the ipsilesional UE patients
experienced degradation in sensory perception (P < .001). CONCLUSION:
Comprehensive sensorimotor assessments based on functional perspectives are valid
tools to determine deficits in the sensation-perception-motor system in the
ipsilesional UE. Integration of sensorimotor training programs for ipsilesional
UE in future neuro-rehabilitation strategies may provide more beneficial effects
to regain patients' motor recovery and to promote daily living activity
independence than focusing on paretic arm motor training alone. LEVEL OF
EVIDENCE: III.
CI - Copyright (c) 2018 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS