Time Course of Wrist Hyper-Resistance in Relation to Upper Limb Motor Recovery Early Post Stroke.
Aukje Andringa, Carel Meskers, Ingrid van de Port and 2 others
PMID 32508291WHAT IT FOUND
Passive wrist resistance became higher in patients who could not extend their fingers early after stroke, while it stayed mostly stable in those who could.
Key findings
01Patients without voluntary finger extension at baseline showed a significant increase in the neural component of wrist hyper-resistance between baseline and week 5, and between weeks 12 and 26.
02At week 26, patients without voluntary finger extension had higher neural, elastic and viscous components than patients with voluntary finger extension.
03Mean Fugl-Meyer upper extremity scores improved from 38 points at baseline to 60 points at week 26 in patients with voluntary finger extension, and from 13 points to 26 points in patients without voluntary finger extension.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study included only 17 patients, so the results are exploratory and could be affected by one person. The study tested several wrist resistance components, so the significant changes need replication in a larger group. Only patients with first-ever ischemic stroke were included, so the findings should not be applied to hemorrhagic stroke. Baseline neural resistance was already higher than healthy controls, so the exact start of the increase is unclear because no measurements were made in the first days after stroke. One patient could not be followed from 12 weeks because passive wrist extension with extended fingers was less than 40 degrees, below the device requirement. The NeuroFlexor model has assumptions that may affect component estimates, including linearity, two set velocities, fixed range, and inability to separate background activation.
Declared interests
The authors declared no potential conflicts of interest. Funding was from the European Research Council, the Netherlands Organisation for Health Research and Development, and an unrestricted grant from IPSEN.
The easy way to misread this
Do not read this as evidence that botulinum toxin or another treatment prevents rising wrist resistance. No patients received botulinum toxin during the study, and the paper only observed how wrist resistance changed over time.