GRASP PATTERN VARIATIONS SEEN IN THE SCLERODERMA HAND

Objectives. Therapists generally describe a person's grasp in terms of normal prehension patterns that have been discussed in the literature . However, the grasp pattern used by a person with a band impairment m ay not fit into these patterns. The purpose of this study was to descr ibe, with qualitative classification systems, static grasp patterns us ed by bands impaired by scleroderma and to determine the relationship between band impairment and variations in grasp.Methods. Seventeen sub jects with scleroderma were observed grasping a key, a coin, a glass, and a saucepan. Their grasp patterns were recorded on the basis of whi ch fingers were used to grasp the object, the surface areas of the fin gers in contact with the object, and the position of the joints of the fingers. In addition, range of motion, grip and pinch strength, skin thickening, digital ulcers, calcium deposits, and tendon function rubs were assessed. Results. More variations in grasp were seen with the c oin, glass, and saucepan than with the key. The presence of digital so res indicated more difficulty bolding a coin, whereas the presence of calcium deposits indicated more difficulty bolding a coin, glass, and saucepan. The number of fingers with contractures correlated with the ability to bold all four objects. Conclusions. Persons with scleroderm a show qualitative differences in grasp as compared to normal prehensi on patterns. These differences are influenced by impairments in the sc leroderma band Qualitative descriptions of grasp patterns may provide therapists with additional means to document change after surgical or therapeutic intervention.