Ann Rehabil Med.  2015 Oct;39(5):752-762. 10.5535/arm.2015.39.5.752.

Relationship Between Grip and Pinch Strength and Activities of Daily Living in Stroke Patients

• Bae JH
• Kang SH
• Seo KM
• Kim DK
• Shin HI
• Shin HE

• KMID: 2148206
• DOI: http://doi.org/10.5535/arm.2015.39.5.752

Abstract

OBJECTIVE
To investigate the relationship between grip and pinch strength and independence in activities of daily living (ADL) in stroke patients.
METHODS
Medical records of 577 stroke patients from January 2010 to February 2013 were retrospectively reviewed. Patients' grip and pinch strength of both hemiplegic and non-hemiplegic hands and the Korean version of Modified Barthel Index (K-MBI) score were collected. These patients were divided into three groups: group A (onset duration: < or =3 months), group B (onset duration: >3 months and <2 years), and group C (onset duration: > or =2 years). The correlation between grip and pinch strength and the K-MBI score was analyzed.
RESULTS
In group A (95 patients), the K-MBI score was significantly (p<0.05) correlated with the grip and pinch strength of both hands in patients with right hemiplegia. Significant (p<0.05) correlation between the K-MBI score and the grip and pinch strength of the hemiplegic hand was shown in patients with left hemiplegia. In group B (69 patients) and group C (73 patients), the K-MBI score was significantly (p<0.05) correlated with the grip and pinch strength of the hemiplegic hand.
CONCLUSION
Stroke patients in subacute stage mainly performed activities of daily living using their dominant hand. However, independence in ADL was associated with the strength of the affected dominant hand. For stroke patients in chronic and late chronic stages, their hand power of the affected hand was associated with independence in ADL regardless whether the dominant hand was affected.

Keyword

Activities of daily living; Functional laterality; Hand strength; Pinch strength; Stroke

MeSH Terms

Activities of Daily Living*
Functional Laterality
Hand
Hand Strength*
Hemiplegia
Humans
Medical Records
Pinch Strength*
Retrospective Studies
Stroke*

Reference

1. Stoykov ME, Corcos DM. A review of bilateral training for upper extremity hemiparesis. Occup Ther Int. 2009; 16:190–203. PMID: 19517519.

2. Jang SH. A review of the ipsilateral motor pathway as a recovery mechanism in patients with stroke. NeuroRehabilitation. 2009; 24:315–320. PMID: 19597268.

3. Lang CE, Bland MD, Bailey RR, Schaefer SY, Birkenmeier RL. Assessment of upper extremity impairment, function, and activity after stroke: foundations for clinical decision making. J Hand Ther. 2013; 26:104–114. PMID: 22975740.

4. Stevenson T, Thalman L, Christie H, Poluha W. Constraint-induced movement therapy compared to dose-matched interventions for upper-limb dysfunction in adult survivors of stroke: a systematic review with meta-analysis. Physiother Can. 2012; 64:397–413. PMID: 23997396.

5. McIntyre A, Viana R, Janzen S, Mehta S, Pereira S, Teasell R. Systematic review and meta-analysis of constraint-induced movement therapy in the hemiparetic upper extremity more than six months post stroke. Top Stroke Rehabil. 2012; 19:499–513. PMID: 23192715.

6. McCombe Waller S, Whitall J. Hand dominance and side of stroke affect rehabilitation in chronic stroke. Clin Rehabil. 2005; 19:544–551. PMID: 16119411.

7. Rinehart JK, Singleton RD, Adair JC, Sadek JR, Haaland KY. Arm use after left or right hemiparesis is influenced by hand preference. Stroke. 2009; 40:545–550. PMID: 19109543.

8. Sangha H, Lipson D, Foley N, Salter K, Bhogal S, Pohani G, et al. A comparison of the Barthel Index and the Functional Independence Measure as outcome measures in stroke rehabilitation: patterns of disability scale usage in clinical trials. Int J Rehabil Res. 2005; 28:135–139. PMID: 15900183.

9. Shah S, Vanclay F, Cooper B. Improving the sensitivity of the Barthel Index for stroke rehabilitation. J Clin Epidemiol. 1989; 42:703–709. PMID: 2760661.

10. Jung HY, Park BK, Shin HS, Kang YK, Pyun SB, Paik NJ, et al. Development of the Korean version of Modified Barthel Index (K-MBI): multi-center study for subjects with stroke. J Korean Acad Rehabil Med. 2007; 31:283–297.

11. Heller A, Wade DT, Wood VA, Sunderland A, Hewer RL, Ward E. Arm function after stroke: measurement and recovery over the first three months. J Neurol Neurosurg Psychiatry. 1987; 50:714–719. PMID: 3612152.

12. Shin H, Moon SW, Kim GS, Park JD, Kim JH, Jung MJ, et al. Reliability of the pinch strength with digitalized pinch dynamometer. Ann Rehabil Med. 2012; 36:394–399. PMID: 22837976.

13. Mathiowetz V, Weber K, Volland G, Kashman N. Reliability and validity of grip and pinch strength evaluations. J Hand Surg Am. 1984; 9:222–226. PMID: 6715829.

14. Goodson A, McGregor AH, Douglas J, Taylor P. Direct, quantitative clinical assessment of hand function: usefulness and reproducibility. Man Ther. 2007; 12:144–152. PMID: 16899386.

15. Li KY, Lin KC, Wang TN, Wu CY, Huang YH, Ouyang P. Ability of three motor measures to predict functional outcomes reported by stroke patients after rehabilitation. NeuroRehabilitation. 2012; 30:267–275. PMID: 22672940.

16. Woldag H, Gerhold LL, de Groot M, Wohlfart K, Wagner A, Hummelsheim H. Early prediction of functional outcome after stroke. Brain Inj. 2006; 20:1047–1052. PMID: 17060137.

17. Skilbeck CE, Wade DT, Hewer RL, Wood VA. Recovery after stroke. J Neurol Neurosurg Psychiatry. 1983; 46:5–8. PMID: 6842200.

18. Puh U. Age-related and sex-related differences in hand and pinch grip strength in adults. Int J Rehabil Res. 2010; 33:4–11. PMID: 19238089.

19. Takeda K, Gomi Y, Imai I, Shimoda N, Hiwatari M, Kato H. Shift of motor activation areas during recovery from hemiparesis after cerebral infarction: a longitudinal study with near-infrared spectroscopy. Neurosci Res. 2007; 59:136–144. PMID: 17681629.

20. Stinear CM, Barber PA, Smale PR, Coxon JP, Fleming MK, Byblow WD. Functional potential in chronic stroke patients depends on corticospinal tract integrity. Brain. 2007; 130(Pt 1):170–180. PMID: 17148468.

21. Han TR, Yoon KJ, Jung SH. The chronological review of uninvolved hand function in stroke patients. J Korean Acad Rehabil Med. 2004; 28:13–19.

22. Haaland KY, Mutha PK, Rinehart JK, Daniels M, Cushnyr B, Adair JC. Relationship between arm usage and instrumental activities of daily living after unilateral stroke. Arch Phys Med Rehabil. 2012; 93:1957–1962. PMID: 22634230.

23. Kim KE, Han TR, Kim JH. Importance of lesion laterality in hand function rehabilitation in stroke patients. J Korean Acad Rehabil Med. 2007; 31:661–667.

24. Harris JE, Eng JJ. Individuals with the dominant hand affected following stroke demonstrate less impairment than those with the nondominant hand affected. Neurorehabil Neural Repair. 2006; 20:380–389. PMID: 16885424.

25. Choi HY, Park SM, Park SJ, Chung KH, Lee YT, Lee PK, et al. Relationship between cognitive-perceptual function and functional independence in patients with ischemic stroke. J Korean Acad Rehabil Med. 2007; 31:630–635.