Characteristics Associated with the Differential Activity of Nondominant and Dominant Affected Hands in Patients with Poststroke Right Hemiparesis.
Jen-Pei Lee, Shuya Chen, Chien-Tsung Tsai and 2 others
PMID 32565757WHAT IT FOUND
Stroke survivors whose dominant hand was affected used their non-affected hand significantly more than their paretic hand, creating strong asymmetry.
However, standard clinical scores for motor function and self-reported use did not correlate with this real-world activity imbalance measured by wearable sensors.
Key findings
01Patients whose dominant hand was affected had significantly lower differential hand activity and a different asymmetry index compared to those whose nondominant hand was affected.
02The amount of real-world hand activity difference measured by wearable sensors did not correlate significantly with Fugl-Meyer motor scores, Motor Activity Log self-reports, or Stroke Impact Scale participation scores.
03Self-reported amount of use (MAL) showed a strong correlation with objective motor impairment scores (Fugl-Meyer), despite not correlating with actual wearable sensor data.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Small sample size (29 participants) limits statistical power and generalizability. The study only included patients with right hemiparesis, so findings may not apply to those with left hemiparesis. Wearable devices measured wrist movement, which may not perfectly equate to specific hand function or dexterity. Participants had relatively high motor function (mean Fugl-Meyer score 45.36), so results may not apply to patients with more severe impairments. The study was observational and did not test an intervention, so it cannot determine if addressing the asymmetry improves outcomes.
Declared interests
The authors declared no conflicts of interest. The study was approved by the Institutional Review Board of China Medical University Hospital.
The easy way to misread this
Do not assume that a patient's self-reported hand use or clinical impairment scores accurately reflect their actual daily activity patterns. The study found no correlation between wearable sensor data and these standard measures, suggesting that patients may significantly under- or over-report their use of the paretic hand in real-world settings.