Okrevanje gibanja zgornjega uda v zgodnjem obdobju po možganski kapi = Motor recovery of upper extremity in the acute stage after stroke
Puh, Urška
The aim of the study was to investigate the characteristics and recovery of upper extremity motor functions the first and the third week as well as three months after stroke. Methods: Twelve ...patients, aged 65 +- 15 years, were included in the study 2-8 days after stroke. All had impaired function of the upper extremity and were right-handed prior to the stroke affecting either left (8 patients) or right (4 patients) hemisphere. The strength of hemiparetic (HPE) and nonhemiparetic (NHPE) upper extremity was evaluated using hand-held dinamometry of 8 muscle groups, hand grip and 3 pinch grips. Dexterity was evaluated by Action research arm test (ARAT) and Nine hole peg test. Results: In measurement 1 Wilcoxon test showed statistical significantly lower values of HPE, compared to NHPE for all 12 strength parameters, 13 ARAT parameters, and Nine hole peg test (p<0.05). The number of statistically significant differences between HPE and NHPE (p<0.05) decreased in measurement 2 (muscle strength: 9; ARAT:11; Nine hole peg test) and measurement 3 (muscle strength: 3; ARAT: 5). From the first to the third measurement, Friedman test showed significant movement recovery of both extremities (p<0.05)(HPE: 9 muscle strength parameters, 10 ARAT parameters, Nine hole peg test; NHPE: 5 muscle strength parameters, 11 ARAT parameters, Nine hole peg test). Conclusions: In stroke patients with partially impaired upper extremity function, many changes of movement characteristics occur gradually during first three months after stroke. Therefore, in this group of stroke patients, it is strongly recommended to perform training of upper extremity functional activities in physiotherapy and occupational therapy as soon as possible after stroke. The training should adapt to a patient' momentary abilities and, if possible, include muscle fatigue.
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