IMPAIRMENTS OF THE ARM AND HAND ARE HIGHLY CORRELATED DURING SUBACUTE STROKE

Background: The classical description of post -stroke upper limb impairment follows a proximal-to-distal impairment gradient. Previous studies are equivocal on whether the hand is more impaired than the arm.Objective: To compare impairment of the arm and hand during subacute stroke. Method: A total of 73 individuals were evaluated for impairment of the upper limb within 30 days (early subacute) and within 90-150 days (late subacute) of stroke. Impairments were quantified using the Chedoke-McMaster Stroke Assessment (CMSA) for the arm and hand, Purdue Pegboard task, and a robotic Visually Guided Reaching task.Results: In the early phase 42% of participants in the early phase and 59% in the late phase recei-ved the same CMSA score for the ar and hand, with 88% and 95% of participants in the early and late phases, respectively, receiving a 1-point difference. Strong correlations exist between the CMSA arm and hand scores (early r = 0.79, late r = 0.75), and moderate - strong correlations exist between CMSA arm and hand scores and Purdue Pegboard and Visually Guided Reaching performances (r = 0.66- 0.81). No systematic differences were found bet-ween the arm and hand.Conclusion: Impairments in the arm and hand during subacute stroke are highly correlated and do not support the presence of a proximal-to-distal gradient.

Automated summary

This study compares the impairment of the arm and hand during subacute stroke and finds a strong correlation between the two, suggesting that there is no proximal-to-distal impairment gradient.