title: Two common tests of dexterity can stratify upper limb motor function after stroke.
abstract: BACKGROUND
  Neurological deficits after a stroke are commonly classified according to motor function for clinical decision making regarding discharge and rehabilitation. Participants in clinical stroke studies are also stratified by motor function to avoid a sampling bias.
  
  
  OBJECTIVE
  This post hoc analysis examined a suite of upper limb functional assessment tools to test the hypothesis that motor function of survivors of stroke can be stratified using 2 simple tests of manual dexterity despite the heterogeneity of the population.
  
  
  METHODS
  The functional ability of the more affected hand and arm was assessed for 67 hemiparetic patients, aged 18 to 83 years (mean ± standard deviation, 59.8 ± 14.0 years), at 1 to 264 months after a stroke (23.6 ± 39.6 months) using the Wolf Motor Function Test (WMFT), upper limb motor Fugl-Meyer Assessment (F-M), Box and Block Test (BBT), grooved pegboard test, and wrist range of motion. We tested the strength of our proposed stratification scheme with a hypothesis-driven hierarchical cluster analysis using standardized raw scores and dichotomous BBT and grooved pegboard test values.
  
  
  RESULTS
  The most salient discriminator between low and higher motor function was the ability to move >1 block on the BBT. Within the higher function group, the ability to place all 25 pegs on the grooved pegboard test discriminated between moderate and high motor function. The derived scheme was congruent with clinical observations. The WMFT timed tasks, F-M scores, and range of motion did not discriminate functional groups.
  
  
  CONCLUSIONS
  Two simple unambiguous and objective tests of gross (BBT) and fine (grooved pegboard test) manual dexterity discriminated 3 groups of motor function ability for a heterogeneous group of patients after stroke.
authors.affiliation: Neuroscience Research Australia, Sydney, Australia University of New South Wales, Sydney, Australia.
authors.forename: Angelica G
authors.initials: AG
authors.lastname: Thompson-Butel
authors.affiliation: Neuroscience Research Australia, Sydney, Australia.
authors.forename: Gaven G
authors.initials: GG
authors.lastname: Lin
authors.affiliation: Neuroscience Research Australia, Sydney, Australia University of New South Wales, Sydney, Australia.
authors.forename: Christine T
authors.initials: CT
authors.lastname: Shiner
authors.affiliation: Neuroscience Research Australia, Sydney, Australia University of New South Wales, Sydney, Australia p.mcnulty@neura.edu.au.
authors.forename: Penelope A
authors.initials: PA
authors.lastname: McNulty
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001132:Arm / Q000503:physiopathology; D016000:Cluster Analysis; D004185:Disability Evaluation; D005260:Female; D006225:Hand / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D010291:Paresis / Q000175:diagnosis; D020521:Stroke / Q000175:diagnosis*; D034941:Upper Extremity / Q000503:physiopathology*; D055815:Young Adult
keywords: Box and Block Test; clinical study design; grooved pegboard test; hierarchical cluster analysis; motor function assessment; poststroke classification