Evaluation of the functional status of the “unaffected” hand in hemiplegic patients

Abstract

Objectives: To evaluate the functional status of the unaffected hand in hemiplegic patients and its relationships with activities of daily living.

Methods: This cross-sectional study included 30 right, 30 left hemiplegic patients with ischemic cerebrovascular accident history in last year, and 30 healthy volunteers. All participants were right-hand dominant. Data on age, gender, height, weight, comorbidities, duration of stroke, Brunnstrom recovery stages were recorded. Handgrip strength (with Jamar-type dynamometer), pinch strengths (with pinch-meter), and hand dexterity [with Nine Hole Peg Test (NHPT)] were evaluated in unaffected hand in patient groups and in both hands in control group. Lawton Instrumental Activities of Daily Living Scale (Lawton-IADL) and Functional Independence Measure (FIM) were applied to patient groups.

Results: Hand grip and pinch strengths were lower, NHPT duration was longer in right (p=0.004, p=0.03, p<0.001) and left (p=0.03, p=0.02, p=0.002) hemiplegia groups compared to control group. Hand grip and pinch strengths were positively, NHPT duration was negatively correlated with FIM self-care performance (r:0.47 p<0.00, r:0.38 p=0.003, r:-0.40 p=0.002), and Lawton-IADL scores (r:0.48 p<0.001, r:0.42 p=0.001, r:-0.56 p<0.001).

Conclusion: Ipsilesional hand, which is considered unaffected, functions are impaired in hemiplegic patients. This functional impairment is associated with greater dependence on activities of daily living.