[Abstract] Relevance of grasp types to assess functionality for personal autonomy

 

Abstract

Study Design

Cross-sectional research design.

Introduction

Current assessment of hand function is not focused on evaluating the real abilities required for autonomy.

Purpose of the Study

To quantify the relevance of grasp types for autonomy to guide hand recovery and its assessment.

Methods

Representative tasks of the International Classification of Functioning, Disability and Health activities in which the hands are directly involved were recorded. The videos were analyzed to identify the grasps used with each hand, and their relevance for autonomy was determined by weighting time with the frequency of appearance of each activity in disability and dependency scales. Relevance is provided globally and distinguished by hand (right-left) and bimanual function. Significant differences in relevance are also checked.

Results

The most relevant grasps are pad-to-pad pinch (31.9%), lumbrical (15.4%), cylindrical (12%), and special pinch (7.3%) together with the nonprehensile (18.6%) use of the hand. Lumbrical grasp has higher relevance for the left hand (19.9% vs 12%) while cylindrical grasp for the right hand (15.3% vs 7.7%). Relevancies are also different depending on bimanual function.

Discussion

Different relative importance was obtained when considering dependency vs disability scales. Pad-to-pad pinch and nonprehensile grasp are the most relevant grasps for both hands, whereas lumbrical grasp is more relevant for the left hand and cylindrical grasp for the right one. The most significant difference in bimanual function refers to pad-to-pad pinch (more relevant for unimanual actions of the left hand and bimanual actions of the right).

Conclusions

The relative importance of each grasp type for autonomy and the differences observed between hand and bimanual action should be used in medical and physical decision-making.

Source: Relevance of grasp types to assess functionality for personal autonomy – Journal of Hand Therapy

[Abstract] The effects of Nintendo WiiTM-based balance and upper extremity training on activities of daily living and quality of life in patients with sub-acute stroke: a randomized controlled study. – PubMed

Abstract

OBJECTIVE:The aim of this study was to investigate the effects of Nintendo WiiTM-based balance and upper extremity training on activities of daily living and quality of life in patients with subacute stroke.

METHODS:42 adults with stroke (mean age (SD) = 58.04 (16.56) years and mean time since stroke (SD) = (55.2 ± 22.02 days (∼8 weeks)) were included in the study. Participants were enrolled from the rehabilitation department of a medical center (a single inpatient rehabilitation facility). Participants were randomly assigned to Nintendo Wii group (n = 20) or Bobath neurodevelopmental treatment (NDT) (n = 22). The treatments were applied for 10 weeks (45-60 minutes/day, 3 days/week) for both of two groups. Nintendo Wii group used five games selected from the Wii sports and Wii Fit packages for upper limb and balance training, respectively. The patients in Bobath NDT group were applied a therapy program included upper extremity activites, strength, balance gait and functional training. The functional independence in daily life activities and health-related quality of life was assessed with Functional Independence Measure (FIM) and Nottingham Health Profile (NHP), respectively. Participant’s treatment satisfaction was recorded by using Visual Analogue Scale. A second evaluation (FIM and NHP) occurred after 10 weeks at the end of rehabilitative treatment (post-training). Treatment satisfaction was measured after 10 sessions.

RESULTS:There were significant difference between FIM and NHP values in NDT and Nintendo Wii group (p < 0.05). However, a significant difference was not found between the groups with regard to FIM and NHP (p > 0.05). The patients in Nintendo Wii group were detected to be better satisfied from the therapy (p < 0.05). A significant difference was found between subparameters and total FIM score, all subparameters and total NHP score in both groups (p < 0.05).

CONCLUSION:These findings suggested that the Nintendo Wii training was as effective as Bobath NDT on daily living functions and quality of life in subacute stroke patients.

Source: The effects of Nintendo WiiTM-based balance and upper extremity training on activities of daily living and quality of life in patients with sub-acu… – PubMed – NCBI