Perceived ability to perform daily hand activities after stroke and associated factors: a cross-sectional study.
BACKGROUND
Despite that disability of the upper extremity is common after stroke, there is limited knowledge how it influences self-perceived ability to perform daily hand activities. The aim of this study was to describe which daily hand activities that persons with mild to moderate impairments of the upper extremity after stroke perceive difficult to perform and to evaluate how several potential factors are associated with the self-perceived performance.


METHODS
Seventy-five persons (72 % male) with mild to moderate impairments of the upper extremity after stroke (4 to 116 months) participated. Self-perceived ability to perform daily hand activities was rated with the ABILHAND Questionnaire. The perceived ability to perform daily hand activities and the potentially associated factors (age, gender, social and vocational situation, affected hand, upper extremity pain, spasticity, grip strength, somatosensation of the hand, manual dexterity, perceived participation and life satisfaction) were evaluated by linear regression models.


RESULTS
The activities that were perceived difficult or impossible for a majority of the participants were bimanual tasks that required fine manual dexterity of the more affected hand. The factor that had the strongest association with perceived ability to perform daily hand activities was dexterity (p < 0.001), which together with perceived participation (p = 0.002) explained 48 % of the variance in the final multivariate model.


CONCLUSIONS
Persons with mild to moderate impairments of the upper extremity after stroke perceive that bimanual activities requiring fine manual dexterity are the most difficult to perform. Dexterity and perceived participation are factors specifically important to consider in the rehabilitation of the upper extremity after stroke in order to improve the ability to use the hands in daily life.
Department of Health Sciences, Lund University, Lund, Sweden. elisabeth.ekstrand@med.lu.se.|Department of Hand Surgery, Skåne University Hospital, Malmö, Sweden. elisabeth.ekstrand@med.lu.se.
Elisabeth
http://orcid.org/0000-0001-6107-5258
E
Ekstrand
Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden.
Lars
L
Rylander
Department of Health Sciences, Lund University, Lund, Sweden.|Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden.|Department of Health Science, Luleå University of Technology, Luleå, Sweden.
Jan
J
Lexell
Department of Health Sciences, Lund University, Lund, Sweden.|Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden.
Christina
C
Brogårdh
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D006225:Hand / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D012649:Self Concept; D020521:Stroke / Q000503:physiopathology* / Q000523:psychology*; D000071939:Stroke Rehabilitation / Q000523:psychology*; D011795:Surveys and Questionnaires; D034941:Upper Extremity / Q000503:physiopathology
Activities of daily living; Association; Cross-sectional study; Rehabilitation; Self report; Stroke; Upper extremity