Effect of Hand Dominance on Functional Status and Recovery of Hand in Stroke Patients

Pınar Muge Sarikaya

doi:10.11648/j.sjcm.20170603.12

Abstract

Stroke is characterized by hemiplegia, including motor deficits and various neurological manifestations mainly in contralateral half of the body lasting more than 24 hours with a presumed vascular cause. The goal of stroke rehabilitation is to make people independent and this is possible with appropriate functioning of the affected hand and upper extremity. Stroke patients have to depend on the nondominant hand when the effected hand is the dominant side. However this disadvantage might end up in better results with more effort for recovery of the dominant hand. In this study, we aimed to understand the effect of hand dominance on both functional loss and regain after stroke. 18 patients with right or left hemiplegia participated in the study. Patients were grouped as dominant side and nondominant side hemiplegic (groups D and ND). Patients were evaluated in the 1st week, 1st month and 3rd month. Brunnstrom stages, Motricity index, MAS and FIM, NHPT and hand grip strength were recorded for every patient in every visit. None of the parameters showed significant difference between two groups. Only NHPT used to assess fine manual dexterity revealed a significant difference in the final analysis. Correlation analysis displayed a positive correlation between hand grip strength with FIM and pinch grip strength with NHPT. We concluded that there was no significant difference in functional improvement between dominant and non-dominant side hemiplegic groups during the first three months after stroke. However longer follow ups and larger patient groups are needed to clarify the effect of hand dominance on long term functional status.

Highlights

Stroke is a clinical syndrome characterized by the rapid onset of focal neurological signs, lasting more than 24 hours or leading to death, with a presumed vascular cause, either due to infarction or haemorrhage
Information on hand dominance was obtained by asking the individual which hand they preferred to use for writing and throwing a ball prior to the stroke
In the light of these data, we concluded that there was no significant difference in functional improvement between dominant and non-dominant side hemiplegic groups during the first three months after stroke

Summary

Introduction

Stroke is a clinical syndrome characterized by the rapid onset of focal neurological signs, lasting more than 24 hours or leading to death, with a presumed vascular cause, either due to infarction or haemorrhage. The most striking finding of stroke is hemiplegia, a clinical condition including motor deficits, sensory disorders, and various neurological manifestations mainly in contralateral half of the body. Manipulative behaviors, based on upper extremity function and used during daily routines and professional life, are often impaired in brain-damaged patients [1, 2]. Despite advances in medical care and rehabilitation, the recovery of hand function following stroke is often limited [3]. The primary goal of stroke rehabilitation is to make patients independent with their daily living activities and this achievement is mainly possible with appropriate functioning of the hand and upper extremity. Hand dominance is an important factor in the performance of motor skills, because the dominant hand is used for many daily and recreational activities. The speed, precision, and coordination of the dominant hand are superior to those of the non- dominant hand, which may stem from motor programs and skills developed through extensive practice and experience associated with the use of dominant hand [4]

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Conclusion