Article

OBJECTIVE: To investigate whether visual feedback of digit force directions for
the index fingertip and thumb tip during repeated practice of grip force
production can correct the digit force directions for persons with stroke during
grip assessments. Following stroke, the paretic fingers generate digit forces
with a higher than normal proportion of shear force to compression force during
grip. This misdirected digit force may lead to finger-object slip and failure to
stably grasp an object. DESIGN: A case series. SETTING: Laboratory. PARTICIPANTS:
Persons (N=11) with severe chronic hand impairment after stroke. INTERVENTIONS:
Four training sessions during which participants practiced directing the index
finger and thumb forces in various target directions during pinch using visual
feedback. MAIN OUTCOME MEASURE: Digit force direction during pinch and clinical
hand function scores were measured before and immediately after the training.
RESULTS: Study participants were able to redirect the digit force closer to the
direction perpendicular to the object surface and increase their hand function
scores after training. The mean ratio of the shear force to the normal force
decreased from 58% to 41% (SD, 17%), the mean Box and Block Test score increased
from 1.4 to 3.4 (SD, 2.0), and the mean Action Research Arm Test score increased
from 10.8 to 12.1 (SD, 1.3) (P<.05 for all 3 measures). CONCLUSIONS: Repeated
practice of pinch with visual feedback of force direction improved grip force
control in persons with stroke. Visual feedback of pinch forces may prove
valuable as a rehabilitation paradigm for improving hand function.
CI - Copyright (c) 2011 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS