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Relative shoulder flexor and handgrip strength is related to upper limb function after stroke
Catherine Mercier1, Daniel Bourbonnais
1Ecole de réadaptation, Université de Montreal and Centre de recherche interdisciplinaire en réadaptation, site IRM, Montréal, QC, Canada.
Clinical Rehabilitation
|April 1, 2004
Summary
Muscle strength in the paretic upper limb (UL) varies significantly, with shoulder flexion and handgrip strength being key predictors of motor function after stroke. These findings challenge traditional views on stroke-related weakness distribution.
Area of Science:
- Neuroscience
- Rehabilitation Medicine
- Kinesiology
Background:
- Stroke often results in upper limb (UL) hemiparesis, impacting motor function and daily activities.
- Understanding the pattern of muscle weakness in the paretic UL is crucial for effective rehabilitation strategies.
Purpose of the Study:
- To compare the relative strength of different muscle groups in the paretic UL.
- To assess the relationship between paretic UL muscle strength and motor performance in chronic hemiparetic stroke survivors.
Main Methods:
- A descriptive study involving 13 chronic hemiparetic stroke subjects in a secondary care rehabilitation setting.
- Maximal active torques of five muscle groups were measured in both ULs and converted to relative strength (paretic/nonparetic).
- UL function was assessed using standardized tests: Box and Block Test, Finger-to-Nose Test, Fugl-Meyer Test, and TEMPA.
Main Results:
- Significant differences were found in the relative strength of different muscle groups (p = 0.017).
- Specific differences were noted between handgrip (0.52 +/- 0.27) and elbow extension (0.73 +/- 0.23) relative strengths.
- Relative shoulder flexion and handgrip strength emerged as the strongest predictors of UL motor function, with high correlation coefficients (0.70-0.81).
Conclusions:
- The study findings do not support traditional clinical assumptions about the gradient of weakness (proximal-to-distal or extensors vs. flexors) post-stroke.
- Evidence supports a strong relationship between the relative strength of specific muscle groups and overall paretic UL motor function.