Development of grip strength during the first year after stroke
Roland Stock, Gyrd Thrane, Torunn Askim, Audny Anke, Paul Jarle Mork
Department of Physical Medicine and Rehabilitation, Trondheim University Hospital, Vådanveien 39, NO-7071 Trondheim, Norway. E-mail: firstname.lastname@example.org
Objective: To assess recovery of grip strength during the first year post-stroke.
Design: Exploratory study on a subsample of patients participating in the Norwegian Constraint-Induced Movement Therapy trial.
Subjects: Eleven patients (mean age 59.1 years; 3 women) with mild to moderate stroke were recruited 7–29 days post-stroke.
Methods: An electronic dynamometer (Biometrics Ltd, Gwent, UK, 2006) was used to assess maximum grip force in 5 hand positions, rate of force development and sustainability of grip force. Similar assessments were performed to assess pinch strength. The participants were assessed 5 times during a 1-year period.
Results: Grip force in the affected hand increased in all handle positions during the 1-year follow-up, mostly during the first 6 months. At 2 and 4 weeks, rate of force development was less than half, and relative sustainability of grip force showed 20–30% greater deficit than for the non-affected hand. The affected hand approached the values of the non-affected hand after 6 months with little further progress until 1-year follow-up.
Conclusion: Grip strength in the affected hand improved considerably in the first year post-stroke. Patterns of improvement were similar across tests, i.e. rapid during the first weeks, slower until 6 months, and minimal 6–12 months post-stroke.
Grip strength is often reduced after a stroke. This affects the ability to maintain grip strength over time and to increase force rapidly. Consequently, this also reduces the ability to cope with everyday activities. This study found that these aspects of grip strength were considerably reduced in the affected hand during the first weeks after stroke in patients with mild to moderate stroke. However, the participants showed good progress during the first year after stroke. All aspects of grip strength improved considerably, especially during the first 6 months. To optimize the improvement in hand function, stroke rehabilitation should have a specific focus on all aspects of grip strength. For instance, practicing the ability to maintain a powerful grip while carrying a shopping bag or increasing force rapidly while squeezing an object.
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