Dataset Information

Estimation of Motor Impairment and Usage of Upper Extremities during Daily Living Activities in Poststroke Hemiparesis Patients by Observation of Time Required to Accomplish Hand Dexterity Tasks.

ABSTRACT: Aim:This study evaluated whether specific actual performance could accurately predict body function levels and upper limb use in the real-life functioning of poststroke hemiparesis patients to aid in choosing the most appropriate rehabilitation exercises. Methods:We measured the time taken for poststroke patients to move small objects with the paralyzed hand and investigated how the measurement could estimate upper extremity motor impairment and hand usage during activities of daily living (ADL). We examined 86 stroke patients (age 66?±?16 years) whose upper extremity motor paralysis was measured using the Fugl-Meyer assessment (FMA) and Southampton Hand Assessment Procedure (SHAP), and patient-reported ADL was investigated using the Jikei Assessment Scale for Motor Impairment in Daily Living (JASMID). To identify the time required to perform each SHAP item, we employed a linear regression analysis. The prediction formula was used in the linear regression analysis, and the coefficient of determination (R 2) was applied to compare each component item score that was obtained with the predicted values derived from the linear regression analysis. Results:The most easily accomplished task was Heavy Power in the SHAP. The R 2 between the SHAP Heavy Power item score and the FMA scores was moderate (R 2?=?0.344, P < 0.0001), whereas the R 2 with the JASMID score was low (R 2?=?0.126, P < 0.001). Conclusions:By measuring the time it takes for poststroke hemiparesis patients to hold and move an object, we developed a prediction formula for upper extremity motor function and hand dexterity.

SUBMITTER: Tanaka T

PROVIDER: S-EPMC6885294 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Estimation of Motor Impairment and Usage of Upper Extremities during Daily Living Activities in Poststroke Hemiparesis Patients by Observation of Time Required to Accomplish Hand Dexterity Tasks.

Tanaka Tomoko T Hamaguchi Toyohiro T Suzuki Makoto M Sakamoto Daigo D Shikano Junpei J Nakaya Naoki N Abo Masahiro M

BioMed research international 20191107

<h4>Aim</h4>This study evaluated whether specific actual performance could accurately predict body function levels and upper limb use in the real-life functioning of poststroke hemiparesis patients to aid in choosing the most appropriate rehabilitation exercises.<h4>Methods</h4>We measured the time taken for poststroke patients to move small objects with the paralyzed hand and investigated how the measurement could estimate upper extremity motor impairment and hand usage during activities of dai ...[more]

PMID: 31828151

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Project description:BackgroundDexterous hand function is crucial for completing activities of daily living (ADLs), which typically require precise hand-object interactions. Kinematic analyses of hand trajectory, hand velocity, and grip aperture provide valuable mechanistic insights into task performance, but there is a need for standardized tasks representative of ADLs that are amenable to motion capture and show consistent performance in non-disabled individuals. Our objective was to develop two standardized functional upper limb tasks and to quantitatively characterize the kinematics of normative hand movement.MethodsTwenty non-disabled participants were recruited to perform two tasks: the Pasta Box Task and Cup Transfer Task. A 12-camera motion capture system was used to collect kinematic data from which hand movement and grip aperture measures were calculated. Measures reported for reach-grasp and transport-release segments were hand distance travelled, hand trajectory variability, movement time, peak and percent-to-peak hand velocity, number of movement units, peak and percent-to-peak grip aperture, and percent-to-peak hand deceleration. A between-session repeatability analysis was conducted on 10 participants.ResultsMovement times were longer for transport-release compared to reach-grasp for every movement. Hand and grip aperture measures had low variability, with 55 out of 63 measures showing good repeatability (ICC > 0.75). Cross-body movements in the Pasta Box Task had longer movement times and reduced percent-to-peak hand velocity values. The Cup Transfer Task showed decoupling of peak grip aperture and peak hand deceleration for all movements. Movements requiring the clearing of an obstacle while transporting an object displayed a double velocity peak and typically a longer deceleration phase.DiscussionNormative hand kinematics for two standardized functional tasks challenging various aspects of hand-object interactions important for ADLs showed excellent repeatability. The consistency in normative task performance across a variety of task demands shows promise as a potential outcome assessment for populations with upper limb impairment.

Project description:In the scientific literature, there is much evidence of a relationship between age and dexterity, where increased age is related to slower, less nimble and less smooth, less coordinated and less controlled performances. While some suggest that the relationship is a direct consequence of reduced muscle strength associated to increased age, there is a lack of research that has systematically investigated the relationships between age, strength and hand dexterity. Therefore, the aim of this study was to examine the associations between age, grip strength and dexterity. 107 adults (range 18-93 years) completed a series of hand dexterity tasks (i.e. steadiness, line tracking, aiming, and tapping) and a test of maximal grip strength. We performed three phases of analyses. Firstly, we evaluated the simple relationships between pairs of variables; replicating the existing literature; and found significant relationships of increased age and reduced strength; increased age and reduced dexterity, and; reduced strength and reduced dexterity. Secondly, we used standard Multiple Regression (MR) models to determine which of the age and strength factors accounted for the greater variance in dexterity. The results showed that both age and strength made significant contributions to the data variance, but that age explained more of the variance in steadiness and line tracking dexterity, whereas strength explained more of the variance in aiming and tapping dexterity. In a third phase of analysis, we used MR analyses to show an interaction between age and strength on steadiness hand dexterity. Simple Slopes post-hoc analyses showed that the interaction was explained by the middle to older aged adults showing a relationship between reduced strength and reduced hand steadiness, whereas younger aged adults showed no relationship between strength and steadiness hand dexterity. The results are discussed in terms of how age and grip strength predict different types of hand dexterity in adults.

Dataset Information

Estimation of Motor Impairment and Usage of Upper Extremities during Daily Living Activities in Poststroke Hemiparesis Patients by Observation of Time Required to Accomplish Hand Dexterity Tasks.

Publications

Estimation of Motor Impairment and Usage of Upper Extremities during Daily Living Activities in Poststroke Hemiparesis Patients by Observation of Time Required to Accomplish Hand Dexterity Tasks.

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