Effect of stroke/PD/MS hand dexterity

[halacey]

Could anyone point me the direction of some statistics for the effect of stroke/PD/or MS on hand dexterity?
I am particularly interested in the numbers of people whose ADL are affected by limited dexterity.

Any help you can give would be most welcome.

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[Judith Mollet]

Seeing how many people have read this and no answers have come up, and I haven't one either, I'm wondering why you are seaching for statistics on such an open ended, never ending question. Is it possible to narrow and specify your interest into an area where research has maybe some answers? I'm a neuro physio with lots of practice but no research post. My statistics say all stroke patients will have functional difficulties sometime. The spectrum will be from immediate post stroke acute to long time functional problems due to various reasons. Where do you want to start? The Parkinson patients have progessive worsening over years and MS as well, with many many variations of presentation of their pathologies. I would say 100% have dexterity problems sometime and therefore 100% will have ADL problems. ADL problems in which specific tasks?? Again, a big variation. Maybe focus your question differently if you are doing some research in a specific area to enable some answers. Good luck

[SagarNaik]

Could anyone point me the direction of some statistics for the effect of stroke/PD/or MS on hand dexterity?
I am particularly interested in the numbers of people whose ADL are affected by limited dexterity.

Any help you can give would be most welcome.

Hi,

I have some statistics for upper extremity dysfunction after stroke but how much it will be helpful to you don't know.

1) Most patients score fewer than 11 points on the Fugl–Meyer upper-extremity test 2 wks after stroke have little chance to recover measurable hand dexterity and are even less likely to recover upper-extremity functional ability.
Reference:
Kwakkel G, Kollen BJ, van der Grond J, Prevo AJ: Probability of regaining dexterity in the flaccid upper limb: impact of severity of paresis and time since onset in acute stroke. Stroke 2003;34:2181–6.

2) 69% of patients admitted to a rehabilitation unit had mild to severe upper extremity disability after stroke. Of this population only 14%-16% with initial upper extremity hemiparesis recover complete or near complete motor function.
Reference:
Gowland, C., H. deBruin, et al. (1992). "Agonist and antagonist activity during voluntary upper-limb movement in patients with stroke." Phys Ther 72(9): 624-33.

3) The absence of a measurable grip function at [almost equal to]1 month after stroke was found to be indicative of a poor functional recovery of the hemiplegic arm.
Reference:
Heller A, Wade DT, Wood VA, Sunderland A, Langton Hewer RL. Arm function after stroke: measurement and recovery over the first three months. J Neurol Neurosurg Psychiatry. 1987; 50: 714–719.

Wade DT, Langton Hewer RL, Wood VA, Skilbeck CE, Ismail HM. The hemiplegic arm and recovery. J Neurol Neurosurg Psychiatry. 1983; 46: 521–524.

Sunderland A, Tinson DJ, Bradley L, Langton Hewer RL. Arm function after stroke: an evaluation of grip strength as a measure of recovery and prognostic indicator. J Neurol Neurosurg Psychiatry. 1989; 52: 1267–1272.

4) Early return of voluntary motion of the paretic arm within the first weeks after stroke is considered to be a good prognostic sign.
Reference:
Wade DT, Langton Hewer RL, Wood VA, Skilbeck CE, Ismail HM. The hemiplegic arm and recovery. J Neurol Neurosurg Psychiatry. 1983; 46: 521–524.

Sunderland A, Tinson DJ, Bradley L, Langton Hewer RL. Arm function after stroke: an evaluation of grip strength as a measure of recovery and prognostic indicator. J Neurol Neurosurg Psychiatry. 1989; 52: 1267–1272.

Twitchell TE. The restoration of motor function following hemiplegia in man. Brain. 1951; 75: 443–480.

5) In general, loss of hand function accounts for about 90% loss of upper extremity function.
Reference: Exact reference I don't know but you can find it from the following book.
Magee, D. J. (2007). Forearm, Wrist & Hand. In: Orthopedic Physical Assessment, 5th Edition, Elsevier Health Sciences.

Hope this might be helpful.

[halacey]

Many thanks for the replies they have been very helpful. I have a very focused question but just wanted some general thoughts from the forum which you have provided.