scholarly journals Validity, reliability, and sensitivity to motor impairment severity of a multi-touch app designed to assess hand mobility, coordination, and function after stroke

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Sara Mollà-Casanova ◽  
Roberto Llorens ◽  
Adrián Borrego ◽  
Bárbara Salinas-Martínez ◽  
Pilar Serra-Añó
Keyword(s):  
Upper Limb ◽  
Convergent Validity ◽  
Hand Function ◽  
Motor Impairment ◽  
Minimal Detectable Change ◽  
Motor Impairments ◽  
Clinical Scales ◽  
Clinical Assessments ◽  
And Function ◽  
Impairment Severity

Abstract Background The assessment of upper-limb motor impairments after stroke is usually performed using clinical scales and tests, which may lack accuracy and specificity and be biased. Although some instruments exist that are capable of evaluating hand functions and grasping during functional tasks, hand mobility and dexterity are generally either not specifically considered during clinical assessments or these examinations lack accuracy. This study aimed to determine the convergent validity, reliability, and sensitivity to impairment severity after a stroke of a dedicated, multi-touch app, named the Hand Assessment Test. Methods The hand mobility, coordination, and function of 88 individuals with stroke were assessed using the app, and their upper-limb functions were assessed using the Fugl-Meyer Assessment for Upper Extremity, the Jebsen-Taylor Hand Function Test, the Box and Block Test, and the Nine Hole Peg Test. Twenty-three participants were further considered to investigate inter- and intra-rater reliability, standard error of measurement, and the minimal detectable change threshold of the app. Finally, participants were categorized according to motor impairment severity and the sensitivity of the app relative to these classifications was investigated. Results Significant correlations, of variable strengths, were found between the measurements performed by the app and the clinical scales and tests. Variable reliability, ranging from moderate to excellent, was found for all app measurements. Exercises that involved tapping and maximum finger-pincer grasp were sensitive to motor impairment severity. Conclusions The convergent validity, reliability, and sensitivity to motor impairment severity of the app, especially of those exercises that involved tapping and the maximum extension of the fingers, together with the widespread availability of the app, could support the use of this and similar apps to complement conventional clinical assessments of hand function after stroke.

scholarly journals The Influence of Primary Motor Cortex Inhibition on Upper Limb Impairment and Function in Chronic Stroke: A Multimodal Study

2019 ◽  
Vol 33 (2) ◽  
pp. 130-140 ◽  
Author(s):  
Ronan A. Mooney ◽  
Suzanne J. Ackerley ◽  
Deshan K. Rajeswaran ◽  
John Cirillo ◽  
P. Alan Barber ◽  
...  
Keyword(s):  
Motor Cortex ◽  
Upper Limb ◽  
Primary Motor Cortex ◽  
Motor Impairment ◽  
Intracortical Inhibition ◽  
Chronic Stroke ◽  
Stroke Patients ◽  
Gaba Concentration ◽  
Chronic Stage ◽  
And Function

Background. Stroke is a leading cause of adult disability owing largely to motor impairment and loss of function. After stroke, there may be abnormalities in γ-aminobutyric acid (GABA)-mediated inhibitory function within primary motor cortex (M1), which may have implications for residual motor impairment and the potential for functional improvements at the chronic stage. Objective. To quantify GABA neurotransmission and concentration within ipsilesional and contralesional M1 and determine if they relate to upper limb impairment and function at the chronic stage of stroke. Methods. Twelve chronic stroke patients and 16 age-similar controls were recruited for the study. Upper limb impairment and function were assessed with the Fugl-Meyer Upper Extremity Scale and Action Research Arm Test. Threshold tracking paired-pulse transcranial magnetic stimulation protocols were used to examine short- and long-interval intracortical inhibition and late cortical disinhibition. Magnetic resonance spectroscopy was used to evaluate GABA concentration. Results. Short-interval intracortical inhibition was similar between patients and controls ( P = .10). Long-interval intracortical inhibition was greater in ipsilesional M1 compared with controls ( P < .001). Patients who did not exhibit late cortical disinhibition in ipsilesional M1 were those with greater upper limb impairment and worse function ( P = .002 and P = .017). GABA concentration was lower within ipsilesional ( P = .009) and contralesional ( P = .021) M1 compared with controls, resulting in an elevated excitation-inhibition ratio for patients. Conclusion. These findings indicate that ipsilesional and contralesional M1 GABAergic inhibition are altered in this small cohort of chronic stroke patients. Further study is warranted to determine how M1 inhibitory networks might be targeted to improve motor function.

scholarly journals Interhemispheric Pathways Are Important for Motor Outcome in Individuals with Chronic and Severe Upper Limb Impairment Post Stroke

2017 ◽  
Vol 2017 ◽  
pp. 1-12 ◽  
Author(s):  
Kathryn S. Hayward ◽  
Jason L. Neva ◽  
Cameron S. Mang ◽  
Sue Peters ◽  
Katie P. Wadden ◽  
...  
Keyword(s):  
Corpus Callosum ◽  
Upper Limb ◽  
Motor Impairment ◽  
Post Stroke ◽  
Significant Difference ◽  
Motor Outcome ◽  
Wolf Motor Function Test ◽  
Severe Group ◽  
And Function ◽  
Motor Outcomes

Background. Severity of arm impairment alone does not explain motor outcomes in people with severe impairment post stroke.Objective. Define the contribution of brain biomarkers to upper limb motor outcomes in people with severe arm impairment post stroke.Methods. Paretic arm impairment (Fugl-Meyer upper limb, FM-UL) and function (Wolf Motor Function Test rate, WMFT-rate) were measured in 15 individuals with severe (FM-UL ≤ 30/66) and 14 with mild–moderate (FM-UL > 40/66) impairment. Transcranial magnetic stimulation and diffusion weight imaging indexed structure and function of the corticospinal tract and corpus callosum. Separate models of the relationship between possible biomarkers and motor outcomes at a single chronic (≥6 months) time point post stroke were performed.Results. Age (ΔR20.365,p=0.017) and ipsilesional-transcallosal inhibition (ΔR20.182,p=0.048) explained a 54.7% (p=0.009) variance in paretic WMFT-rate. Prefrontal corpus callous fractional anisotropy (PF-CC FA) alone explained 49.3% (p=0.007) variance in FM-UL outcome. The same models did not explain significant variance in mild–moderate stroke. In the severe group, k-means cluster analysis of PF-CC FA distinguished two subgroups, separated by a clinically meaningful and significant difference in motor impairment (p=0.049) and function (p=0.006) outcomes.Conclusion. Corpus callosum function and structure were identified as possible biomarkers of motor outcome in people with chronic and severe arm impairment.

Hand function development of children with hemiplegic cerebral palsy: A scoping review

2021 ◽  
pp. 1-26
Author(s):  
James V. McCall ◽  
Miranda C. Ludovice ◽  
Catherine Elliott ◽  
Derek G. Kamper
Keyword(s):  
Cerebral Palsy ◽  
Scoping Review ◽  
Muscle Activation ◽  
Hand Function ◽  
Activation Patterns ◽  
Clinical Scales ◽  
Clinical Assessments ◽  
Assessment Scores ◽  
Muscle Activation Patterns ◽  
Hemiplegic Cerebral Palsy

PURPOSE: Hemiplegic cerebral palsy (hCP) typically impacts sensorimotor control of the hand, but comprehensive assessments of the hands of children with hCP are relatively rare. This scoping review summarizes the development of hand function for children with hCP. METHODS: This scoping review focused on the development of hand function in children with hCP. Electronic databases (PubMed, PEDro, Web of Science, CINAHL, and SpringerLink) were searched to identify studies assessing hand function in children with hCP. The search was performed using keywords (e.g., “hemiplegia”). An iterative approach verified by two authors was used to select the studies. Articles which reported quantitative data for children with hCP on any items of a specified set of hand evaluations were included. Measures were sorted into three categories: quantitative neuromechanics, clinical assessments, and clinical functional evaluations. RESULTS: Initial searches returned 1536 articles, 131 of which were included in the final review. Trends between assessment scores and age were examined for both hands. CONCLUSION: While several studies have evaluated hand function in children with hCP, the majority relied on clinical scales, assessments, or qualitative descriptions. Further assessments of kinematics, kinetics, and muscle activation patterns are needed to identify the underlying impairment mechanisms that should be targeted for treatment.

scholarly journals Muscle Synergies and Clinical Outcome Measures Describe Different Factors of Upper Limb Motor Function in Stroke Survivors Undergoing Rehabilitation in a Virtual Reality Environment

Sensors ◽  
2021 ◽  
Vol 21 (23) ◽  
pp. 8002
Author(s):  
Lorenza Maistrello ◽  
Daniele Rimini ◽  
Vincent C. K. Cheung ◽  
Giorgia Pregnolato ◽  
Andrea Turolla
Keyword(s):  
Factor Analysis ◽  
Regression Model ◽  
Upper Limb ◽  
Motor Impairment ◽  
Muscle Synergy ◽  
Muscle Synergies ◽  
Clinical Scales ◽  
Clinical Variables ◽  
Rehabilitation Protocols ◽  
General Linear Regression Model

Recent studies have investigated muscle synergies as biomarkers for stroke, but it remains controversial if muscle synergies and clinical observation convey the same information on motor impairment. We aim to identify whether muscle synergies and clinical scales convey the same information or not. Post-stroke patients were administered an upper limb treatment. Before (T0) and after (T1) treatment, we assessed motor performance with clinical scales and motor output with EMG-derived muscle synergies. We implemented an exploratory factor analysis (EFA) and a confirmatory factor analysis (CFA) to identify the underlying relationships among all variables, at T0 and T1, and a general linear regression model to infer any relationships between the similarity between the affected and unaffected synergies (Median-sp) and clinical outcomes at T0. Clinical variables improved with rehabilitation whereas muscle-synergy parameters did not show any significant change. EFA and CFA showed that clinical variables and muscle-synergy parameters (except Median-sp) were grouped into different factors. Regression model showed that Median-sp could be well predicted by clinical scales. The information underlying clinical scales and muscle synergies are therefore different. However, clinical scales well predicted the similarity between the affected and unaffected synergies. Our results may have implications on personalizing rehabilitation protocols.

scholarly journals Effectiveness of hand splints on upper limb skills and functional activities in children with cerebral palsy: a review

2021 ◽  
Vol 8 (5) ◽  
pp. 2614
Author(s):  
Rohina Kumari ◽  
Surbhi . ◽  
Sakshi Saharawat
Keyword(s):  
Cerebral Palsy ◽  
Muscle Strength ◽  
Upper Limb ◽  
Hand Function ◽  
Cochrane Library ◽  
Fine Motor ◽  
Functional Activities ◽  
Quality Of Motion ◽  
Motor Dexterity ◽  
And Function

Cerebral Palsy is a non-progressive neurological disorder in which children may experience similar physical limitations, including those related to upper limb skills that affect the child's ability to participate in age-specific activities. The use of hand-splints in children with neurological conditions is little reported, they continue to be widely used to improve upper limb skills and functional activities. This review was done to investigate the use and effects of hand splints in Cerebral Palsy patient as orthotic treatment found to be very positive result in correcting and maintaining the achieved results. Electronic database search was conducted using Google scholar, Science direct, Pub Med, Cochrane Library and reference lists from all retrieved articles. Common problems in upper limb due to CP are flexion contractures of the fingers and wrist due to spasticity, pronation deformity of the forearm, thumb-in-palm deformity and hand-related disabilities, all lead to decrease in grip and muscle strength. Hand splints are often used to help a weak or ineffective joint or muscle to enhance a person's arm or hand posture, mobility, quality of motion, and function. The findings suggest that children with CP experience increased grip strength and fine motor dexterity when using different hand splints. This review summarizes the present state of understanding the extent to which orthotic management in CP can improve in the patient’s skills and functional activities by improving the muscle strength and hand function, also offers clinical suggestions for prescribing orthosis in order to optimize efficacy.

Quantifying upper limb motor impairment in chronic stroke: a physiological profiling approach

2021 ◽  
Author(s):  
Lewis Anthony Ingram ◽  
Annie A. Butler ◽  
Matthew Andrew Dalhousie Brodie ◽  
Stephen Ronald Lord ◽  
Simon C. Gandevia
Keyword(s):  
Upper Limb ◽  
Test Performance ◽  
Motor Impairment ◽  
Chronic Stroke ◽  
Anatomical Location ◽  
Sensorimotor Function ◽  
Upper Limbs ◽  
Motor Impairments ◽  
Upper Limb Function ◽  
Stroke Population

Upper limb motor impairments, such as muscle weakness, loss of dexterous movement and reduced sensation are common following a stroke. The extent and severity of these impairments differs among individuals, depending on the anatomical location and size of lesions. Identifying impairments specific to the individual is critical to optimize their functional recovery. The upper limb Physiological Profile Assessment (PPA) provides quantitative measures of key physiological domains required for adequate function in the upper limbs. The current study investigates the use of the upper limb PPA in a chronic stroke population. 50 participants with chronic stroke completed all tests of the upper limb PPA; both with their affected and less affected upper limbs. Performance in each test was compared to 50 age- and sex matched controls with no history of a stroke. Correlations between test performance and validated measures of stroke, sensorimotor function and disability were examined. Compared to controls, people with stroke demonstrated substantially impaired upper limb PPA performance for both their affected and less affected limbs. Performance in the upper limb PPA was associated with validated measures of sensorimotor function specific to the stroke population (Fugl-Meyer Assessment), and stroke-related disability (Stroke Impact Scale). The upper limb PPA shows good concurrent validity as a means of to quantify upper limb function in a chronic stroke population. These tests identify domain-specific deficits and could be further tailored to an individual patient by the clinician to inform rehabilitation and track recovery.

scholarly journals Assessment of hand function in women with lymphadenopathy after radical mastectomy

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e11252
Author(s):  
Subham Mistry ◽  
Taimul Ali ◽  
Mohammed Qasheesh ◽  
Rashid Ali Beg ◽  
Mohammad Abu Shaphe ◽  
...  
Keyword(s):  
Grip Strength ◽  
Upper Limb ◽  
Healthy Adult ◽  
Handgrip Strength ◽  
Hand Function ◽  
Hand Grip Strength ◽  
Adult Women ◽  
Hand Functions ◽  
Hand Grip ◽  
And Function

Background Breast cancer related upper limb lymphedema (BCRL) is a common complication in post-mastectomy patients. It is known to cause upper limb disability, which subsequently may affect the grip strength and hand function. There is little evidence on the objective assessment of functional activities particularly hand function in women with BCRL. Therefore, this study objectively assesses the handgrip strength and hand functions in women with BCRL. Method A cross-sectional study design was conducted on a sample of women with (n = 31) and without (n = 31) BCRL. The Handgrip strength and hand functions were measured using a dynamometer and Jebsen-Taylor hand function test, respectively. Results The results showed a significantly reduced handgrip strength in women with BCRL as compared to age-matched healthy adult women for both right and left hands (p < 0.05). Similarly, hand functions were significantly impaired in women with BCRL as compared to healthy adult women (p < 0.05). Reduction in handgrip strength and hand function in women with BCRL were clinically meaningful as indicated by moderate to large effect sizes (Cohen’s d = 0.61 to 0.99 and 0.54 to 3.02, respectively) in all outcomes except power handgrip strength in left hand (Cohen’s d = 0.38). Conclusion The results of this study indicate a significant reduction of hand grip strength and hand function in women with BCRL. Our findings suggest that objective measures of grip strength and function be included in the assessment of women with BCRL to better guide clinical decision making and patient care, which may include management of impairment associated with hand strength and function. Future studies that evaluate hand grip strength and function in a larger sample which includes a more diverse age group of women with BCRL are warranted to confirm the current findings.

Sign in / Sign up

Export Citation Format

Share Document