Gp. Prigatano et Jl. Wong, SPEED OF FINGER TAPPING AND GOAL ATTAINMENT AFTER UNILATERAL CEREBRALVASCULAR ACCIDENT, Archives of physical medicine and rehabilitation, 78(8), 1997, pp. 847-852
Objective: To determine (1) if speed of finger tapping is bilaterally
slow after an acute unilateral cerebral vascular accident (CVA) and (2
) if speed of finger tapping and grip strength are related to achievin
g rehabilitation goals during the first few weeks after stroke. Design
: Prospective inception cohort study. Study Setting: Medical center an
d neurological institute. Participants: Fifty-one patients with unilat
eral CVAs. Main Outcome Measures: Documentation of goal attainment at
discharge and bilateral measures of speed of finger tapping and grip s
trength. Results: Speed of finger tapping and grip strength were often
bilaterally below normal limits after an acute unilateral CVA, with t
he contralateral hand most affected. Speed of finger tapping, but not
grip strength, in the ipsilateral hand was associated with achieving r
ehabilitation goals. Speed of finger tapping in the contralateral hand
as well as bilateral grip strength was not related to achievement of
rehabilitation goals. Conclusions: Motor findings suggest that bilater
al cerebral dysfunction may be common after an acute unilateral CVA. T
he speed of finger movement in the hand ipsilateral to the lesion may
reflect the degree to which the so-called ''unaffected'' cerebral hemi
sphere has in fact maintained its functional integrity. As such, it ma
y be a useful behavioral marker for predicting goal attainment during
early stages of neurorehabilitation. (C) 1997 by the American Congress
of Rehabilitation Medicine and the American Academy of Physical Medic
ine and Rehabilitation.