Loss of strength contributes more to physical disability after stroke than loss of dexterity.
OBJECTIVE
The major contributors to physical disability after stroke are considered to be the negative impairments of loss of dexterity (defined here as loss of the ability to co-ordinate muscle activity in the performance of any motor task) and loss of strength. The aims of this study were: (1) to determine the relative contributions of strength and dexterity to function during recovery after stroke; and (2) to determine the predictive value of initial strength, dexterity and function on long-term function after stroke.


METHODS
A longitudinal descriptive study.


METHODS
The inpatient and outpatient rehabilitation departments of two metropolitan hospitals.


METHODS
Twenty-two patients undergoing rehabilitation after acute stroke participated.


METHODS
Strength and dexterity of the elbow flexors and extensors were measured, along with arm function, at 3, 5, 7, 9, 11, 15, 19, 23 and 27 weeks after stroke.


RESULTS
Standard multiple linear regression analysis demonstrated that strength and dexterity in total contributed significantly to function at all times (r2 = 0.66-0.82, p < 0.0001). Furthermore, strength always made an additional separate contribution to function (r2 = 0.05-0.26, p < 0.05). Function at week 3 was the best clinical predictor of function at week 27 (r2 = 0.55, p < 0.001).


CONCLUSIONS
Loss of strength is a more significant contributor than loss of dexterity to physical disability after stroke. This suggests that, where significant weakness is present, exercise designed to increase strength will be required to decrease disability.
Canning
Colleen G
CG
School of Physiotherapy, The University of Sydney, NSW, Australia. C.Canning@fhs.usyd.edu.au
Ada
Louise
L
Adams
Roger
R
O'Dwyer
Nicholas J
NJ
D000368:Aged; D000369:Aged, 80 and over; D006233:Persons with Disabilities; D004551:Elbow Joint / Q000502:physiology; D005260:Female; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D019957:Motor Skills Disorders / Q000209:etiology*; D018908:Muscle Weakness / Q000473:pathology*; D020521:Stroke / Q000150:complications*; D000071939:Stroke Rehabilitation