Abstract
Hand motor impairment is common after stroke but there are few comprehensive data on amount of hand movement. This study aimed to compare the amount of thumb and finger movement over an extended period of time in people with stroke and able-bodied people. Fifteen stroke subjects and 15 able-bodied control subjects participated. Stroke subjects had impaired hand function. Movement of the thumb and index finger was recorded using stretch sensors worn on the affected hand (stroke subjects) or the left or right hand (control subjects) for ∼4 hours during the day. A digit movement was defined as a monotonic increase or decrease in consecutive sensor values. Instantaneous digit position was expressed as a percentage of maximal digit flexion. Mixed linear models were used to compare the following outcomes between groups: (1) average amplitude of digit movement, (2) digit cadence and average digit velocity, (3) percentage of digit idle time and longest idle time. Amplitude of digit movement was not different between groups. Cadence at the thumb (between-group mean difference, 95% CI, p value: -0.6 movements/sec, -1.0 to -0.2 movements/sec, p = 0.003) and finger (-0.5 movements/sec, -0.7 to -0.3 movements/sec, p<0.001) was lower in stroke than control subjects. Digit velocity was not different between groups. Thumb idle time was not different between groups, but finger idle time was greater in stroke than control subjects (percentage of idle time: 6%, 1 to 11%, p = 0.02; longest idle time: 375 sec, 29 to 721 sec, p = 0.04). Rehabilitation after stroke should encourage the performance of functional tasks that involve movements at faster cadences, and encourage more frequent movement of the digits with shorter periods of inactivity.
Highlights
Motor impairment at the hand is common after stroke [1]
Stroke subjects were sampled broadly to obtain a representative sample of people with stroke, and could be receiving either inpatient or outpatient rehabilitation
Stroke subjects wore the sensors for median 3.3 hours and control subjects for 3.1 hours (2.3 to 3.7 hours)
Summary
Motor impairment at the hand is common after stroke [1]. At 6 months after severe stroke, one third of people develop wrist and hand contracture (loss of passive joint range of motion) [2] and more than 50% of people with hand impairments do not regain function [3]. The loss of functional hand movement is disabling and can persist for many years [4].
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