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Recovery of dexterous hand use is critical for functional outcome after stroke. Grip force recordings can inform on maximal motor output and modulatory and inhibitory cerebral functions, but how these actually contribute to recovery of dexterous hand use is unclear. This cohort study used serially assessed measures of hand kinetics to test the hypothesis that behavioural measures of motor modulation and inhibition explain dexterity recovery beyond that explained by measures of motor output alone. We also investigated the structural and functional connectivity correlates of grip force control recovery. Eighty-nine adults (median age = 54 years, 26% females) with first-ever ischaemic or haemorrhagic stroke and persistent arm and hand paresis were assessed longitudinally, at 3 weeks, and at 3 and 6 months after stroke. Kinetic measures included: maximal grip force, accuracy of precision and power grip force control, and ability to release force abruptly. Dexterous hand use was assessed clinically with the Box and Block Test and motor impairment with the upper extremity Fugl-Meyer Assessment. Structural and functional MRI was used to assess weighted corticospinal tract lesion load, voxel-based lesion symptom mapping and interhemispheric resting-state functional connectivity. Fifty-three per cent of patients had severe initial motor impairment and a majority still had residual force control impairments at 6 months. Force release at 3 weeks explained 11% additional variance of Box and Block Test outcome at 6 months, above that explained by initial scores (67%). Other kinetic measures did not explain additional variance of recovery. The predictive value of force release remained significant when controlling for corticospinal tract lesion load and clinical measures. Corticospinal tract lesion load correlated with recovery in grip force control measures. Lesions involving the parietal operculum, insular cortex, putamen and fronto-striatal tracts were also related to poorer force modulation and release. Lesions to fronto-striatal tracts explained an additional 5% of variance in force release beyond the 43% explained by corticospinal injury alone. Interhemispheric functional connectivity did not relate to force control recovery. We conclude that not only voluntary force generation but also force release (reflecting motor inhibition) are important for recovery of dexterous hand use after stroke. Although corticospinal injury is a main determinant of recovery, lesions to integrative somatosensory areas and fronto-parietal white matter (involved in motor inhibition) explain additional variance in post-stroke force release recovery. Our findings indicate that post-stroke upper limb motor impairment profiling, which is essential for targeted treatment, should consider both voluntary grasp generation and inhibition.
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http://dx.doi.org/10.1093/braincomms/fcac241 | DOI Listing |
Int J Sports Physiol Perform
December 2024
Department of Anesthesiology and Intensive Care, Akershus University Hospital, Lørenskog, Norway.
Purpose: Laboratory studies have demonstrated that manual dexterity decreases with increasing cold, which may adversely affect performance. Dexterity may be impaired by cooling of the hand, cooling of the lower motor neurons, and cognitive impairment. Wetsuits are commonly used in open-water swimming and are mandated in some situations.
View Article and Find Full Text PDFJ Neuroeng Rehabil
December 2024
Department of Biomedical Engineering, University of Utah, Salt Lake City, UT, USA.
Background: This research aims to improve the control of assistive devices for individuals with hemiparesis after stroke by providing intuitive and proportional motor control. Stroke is the leading cause of disability in the United States, with 80% of stroke-related disability coming in the form of hemiparesis, presented as weakness or paresis on half of the body. Current assistive exoskeletonscontrolled via electromyography do not allow for fine force regulation.
View Article and Find Full Text PDFJ Orthop
June 2025
Department of Orthopedic and Trauma Surgery, University of Heidelberg, Schlierbacher Landstraße 200a, 69118, Heidelberg, Germany.
Background: Total shoulder arthroplasty (TSA) is a successful treatment method for patients with end-stage glenohumeral osteoarthritis and different factors influencing the clinical outcome have been determined. However, the role of hand dominance on the postoperative clinical results and implant survival is not well analyzed. Hypothesis: Hand Dominance does not influence the outcome after TSA.
View Article and Find Full Text PDFJ Dent Educ
December 2024
Faculty of Health & Life Sciences, Institute of Life Course and Medical Sciences, School of Dentistry, University of Liverpool, Liverpool, UK.
Background: Haptics-enhanced virtual reality (VR-haptic) simulation in dental education has evolved considerably during the past decade, representing a promising resource of simulation-based training opportunities to support conventional practice. We aim to summarize current literature on the applications of VR-haptics in learning, practicing, and teaching dental education.
Methods: A literature search was performed using PubMed, focusing on research articles published between January 2010 and January 2024.
J Atten Disord
December 2024
Pamukkale University, School of Medicine, Department of Physical Medicine and Rehabilitation, Denizli, Turkey.
Objective: The study aimed to investigate whether the fine motor skills measured by the Functional Dexterity Test (FDT) in ADHD children differ from healthy controls. The second aim was to assess the applicability of the FDT assessment method among ADHD children.
Method: The FDT results as an objective assessment of hand skills were compared between 7 and 17 years old ADHD cases ( = 146) and age and gender-matched healthy controls ( = 213).
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