The added value of kinematic evaluation of the timed finger-to-nose test in persons post-stroke.
Gudrun M Johansson, Helena Grip, Mindy F Levin and 1 others
PMID 28183337WHAT IT FOUND
Persons post-stroke completed the finger-to-nose test slower, with less smooth, less straight and less accurate pointing and more trunk and shoulder-blade movement.
Even when their time matched controls, these movement differences remained.
Key findings
01Persons post-stroke completed the finger-to-nose test more slowly than controls (mean difference 2.6 s).
02Even when movement times were matched, persons post-stroke still had greater pointing error and more trunk or shoulder-blade movement than controls.
03Persons with moderate stroke had longer pointing time than those with mild stroke (mean difference 0.3 s) and smaller elbow flexion range of motion (mean difference 14.4 degrees).
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 stroke participants had mild to moderate impairment and were able to lift the hand to the nose, so the findings do not apply to severe hemiparesis. The sample size limited the regression model and subgroup analysis, and the mild and moderate stroke groups were unequal in size. The authors used a very conservative correction for many comparisons, which can hide real differences. The analysis focused on the pointing phase and did not describe the whole test performance.
The easy way to misread this
Do not read a shorter finger-to-nose time as proof of improved coordination. In time-matched groups, persons post-stroke still had greater pointing error and more trunk or shoulder-blade movement, and a faster time may be a false improvement if accuracy is sacrificed.