SPEED OF FINGER TAPPING AND GOAL ATTAINMENT AFTER UNILATERAL CEREBRALVASCULAR ACCIDENT

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.