Limited fine hand use after stroke and its association with other disabilities.

OBJECTIVE To describe the recovery of fine hand use and the associations between fine hand use and, respectively, somatosensory functions, grip strength, upper extremity movements and self-care, in the first week and at 3 and 18 months after stroke, and to describe whether these associations change over time. DESIGN Prospective observational study. PATIENTS Sixty-six consecutive patients with stroke. METHODS The following parameters were assessed in the first week, and at 3 and 18 months after stroke: fine hand use, grip strength (not assessed in the first week), touch, proprioceptive and upper extremity movement functions; and self-care. RESULTS Seventy percent of all patients had limited fine hand use in the first week, 41% at 3 months and 45% at 18 months after stroke. The associations between fine hand use and the other functioning were moderate to high, but decreased over time for fine hand use and, respectively, somatosensory functions, upper extremity movements and self-care. CONCLUSION Limited fine hand use is common after acute stroke. Our results suggest that, with time after stroke, upper extremity movements and self-care become less dependent on fine hand use and fine hand use becomes less dependent on touch function, although no ultimate conclusions can be drawn on causality.

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