Motor Coordination and Grip Strength of the Dominant and Non-Dominant Affected Upper Limb Depending on the Body Position-An Observational Study of Patients after Ischemic Stroke.

Anna Olczak,Aleksandra Truszczyńska-Baszak

doi:10.3390/brainsci12020164

Abstract

Stroke is one of the leading causes of human disability globally. Motor function deficits resulting from a stroke affect the entire body, but relatively often it is the upper limbs that remain ineffective, which is very limiting in everyday life activities. The finding in neurorehabilitation that trunk control contributes to upper limb function is relatively common but has not been confirmed in clinical trials. This observational prospective study aims to analyze the effect of the position of the trunk and the affected upper limb on the coordination and grip strength of the affected dominant and non-dominant hand and wrist in people after ischemic stroke. The research was carried out at the Department of Neurological Rehabilitation, on a group of 60 patients with acute ischemic stroke. A Hand Tutor device and a hand dynamometer were used for the main measurements of the motor coordination parameters (maximum range of motion, frequency of movement) and the grip strength of the dominant and non-dominant upper limb. The patients were examined in two positions: sitting without back support and lying on the back with stabilization of the upper limb. Higher and relevant results were observed in the non-dominant hand, in the supine position in terms of motor coordination parameters of the fingers (p = 0.019; p = 0.011) and wrist (p = 0.033), and grip strength (p = 0.017). Conclusions: The laying position and stabilization of the affected upper limb in the acute phase following ischemic stroke is more beneficial for the coordination of movements and grip strength of the non-dominant hand.

Highlights

Lateralization, or sidedness or functional asymmetry of the right and left sides of the human body, results from differences in the structure and functions of the cerebral hemispheres, and is a consequence of the domination of one of the hemispheres [1]
Patients for whom the non-dominant hand was examined had higher scores only for max range of movement (ROM) F3 and F4 compared to patients with the dominant hand (Table 3)
Lying with stabilization of the affected upper limb resulted in an improvement in most of the parameters studied: frequency of wrist and finger movements from 2 to 5, and Maximum range of motion (max ROM) of fingers from 5 to 3, in addition to hand grip strength (Table 4)

Summary

Introduction

Lateralization, or sidedness or functional asymmetry of the right and left sides of the human body, results from differences in the structure and functions of the cerebral hemispheres, and is a consequence of the domination of one of the hemispheres [1]. It is expressed, for example, by greater mobility of the right limbs than the left ones, in addition to the registration by the brain of a greater number of sensory stimuli coming from one side of the body [2,3]. When the dominant hand is on the same side of the body as the dominant eye, the so-called hand–eye system, which is the basis of eye–hand coordination, enables and greatly facilitates the performance of graphic and manipulative activities [7,8,9]

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