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Updated: Sep 29, 2026

Utility of Dissociated Intrinsic Hand Muscle Atrophy in the Diagnosis of Amyotrophic Lateral Sclerosis
Published on: March 4, 2014
Prediction of reflex sympathetic dystrophy in hemiplegia by evaluation of hand edema
Manabu Iwata1, Izumi Kondo, Yoshihiro Sato
1Department of Physical Therapy, School of Health Sciences, Hirosaki University, Hirosaki-shi , Japan.
Objective:
To determine the predictive value of measurements of hand edema for the development of reflex sympathetic dystrophy (RSD).
Design:
Cohort study.
Setting:
Departments of rehabilitation medicine in 3 general hospitals and 1 rehabilitation hospital in Japan.
Participants:
Thirty-four stroke patients.
Interventions:
Not applicable.
Main Outcome Measures:
Measurement of the circumference of the middle finger was used to evaluate hand edema. The degree of hand edema was expressed by the ratio of circumference of the middle finger (RCMF) in the affected side to that in the uninvolved extremity.
Results:
Eight of 34 patients developed clinical RSD from 2 to 4 months after stroke. Hand edema showed a significant relationship to the development of RSD (ie, the patients who had an RCMF of above 1.06 at 4 weeks poststroke had significantly higher incidence of RSD than those with a lower RCMF; P=.0127).
Conclusion:
It is possible to predict the development of RSD in hemiplegia by measuring hand edema 4 weeks poststroke.
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