PTOTOtherArchives of physical medicine and rehabilitation2020

Survivors of Chronic Stroke Experience Continued Impairment of Dexterity But Not Strength in the Nonparetic Upper Limb.

Alexander J Barry, Kristen M Triandafilou, Mary Ellen Stoykov and 3 others

PMID 32113974

WHAT IT FOUND

In chronic stroke survivors with severe paretic hand impairment, the nonparetic hand showed impaired dexterity but not grip strength, despite long reliance on that limb.

Key findings

01The nonparetic hand was slower on dexterity tasks and moved fewer blocks than matched norms, and palmar pinch was reduced, but maximum grip strength was not.

02When the non-dominant group was compared with dominant-hand norms, writing and simulated feeding were especially poor.

03Time since stroke did not relate to nonparetic hand performance.

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

The study used a convenience sample of 40 participants, so the findings may not represent all chronic stroke survivors. Only people with severe paretic hand impairment were included, so results may not apply to milder stroke. There were no concurrent control participants, so comparisons depended on published normative data. The study was cross-sectional and did not test therapy, so it cannot show whether treating the nonparetic hand helps. Participants were selected from the baseline of a larger intervention study, which may limit generalisability.

Declared interests

The authors declared no conflicts of interest. The article is listed as supported by NIH extramural research.

The easy way to misread this

Do not conclude that the nonparetic hand is normal because grip strength was normal. Dexterity was impaired in this sample, and only people with severe paretic hand impairment were studied.

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