Importance of Lesion Laterality in Hand Function Rehabilitation in Stroke Patients

Kim, Kyoung Eun; Han, Tai Ryoon; Kim, Jung Hwan

Abstract

OBJECTIVE
To investigate the relationship between the independence levels of ADL and the function of affected and unaffected hands using Modified Barthel Index (MBI) and Jebsen Hand Function Test (JHFT) at subacute and chronic stages of stroke. METHOD: Retrospective review was performed including unilateral stroke patients who had been admitted and evaluated with MBI and JHFT before discharge and 6 months after stroke onset. Correlations between sub-MBI related to hand function and JHFT were analyzed.
RESULTS
Thirty-one patients with dominant hemispheric lesion and 13 patients with non-dominant hemispheric lesion were included in this analysis. The evaluation was performed at 43.2+/-28.0 days post-stroke before discharge and followed at 200.0+/-46.1 days post-stroke. MBI scores and the JHFT scores of affected hand were significantly increased in both groups. At the time of discharge, both groups showed significant correlations between MBI scores and the JHFT scores of unaffected hand, but at 6 months post-stroke, significant correlations were found between MBI scores and the JHFT scores of dominant hand. Improvement of the 'stacking checker' item was significantly correlated with improvement of MBI in both groups.
CONCLUSION
In subacute stage, MBI reflects the function of unaffected hand, but in chronic stage, it rather reflects the function of dominant hand. The results suggest that rehabilitation concerning hand function may need different approach according to the lesion laterality.