Impact of Hand Grip Strength on Functional Independence and Arm Motor Performance in Stroke Survivors
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Abstract
Background: Stroke remains a leading cause of disability worldwide, with a significant number of survivors experiencing impairments in upper limb function and hand grip strength, which are crucial for performing activities of daily living (ADLs). Understanding the relationship between hand grip strength, functional independence, and arm motor performance is essential for optimizing rehabilitation strategies.
Objective: This study aimed to investigate the impact of hand grip strength on functional independence and arm motor performance in stroke survivors and to evaluate the effectiveness of Mirror Therapy in enhancing these outcomes.
Methods: An analytical cross-sectional study was conducted at DHQ Teaching Hospital Sargodha, involving 22 stroke survivors, evenly split between genders. Participants were aged 45-65 years, clinically diagnosed with ischemic stroke in the subacute stage, and exhibited Modified Ashworth Scale scores of 1 to 1+ for hand flexors. The study employed randomized assignments to intervention groups, utilizing assessments such as the Action Research Arm Test (ARAT), Fugl-Meyer Assessment for Upper Extremity (FMA UE), Hand-Held Dynamometer (HHD), and Stroke Impact Scale (SIS) at baseline, 3 weeks, and 6 weeks. Statistical analysis was performed using Pearson’s coefficient of correlation with SPSS version 25.
Results: Significant improvements were observed in upper limb strength and hand dexterity, particularly in the group undergoing Mirror Therapy. The correlation coefficients among ARAT, HHD, and SIS were .676**, .748**, and .704** respectively, indicating strong positive relationships between hand grip strength, functional ability, and quality of life. Mirror Therapy demonstrated notable enhancements in ARAT (p = .001), FMA UE (p < .000), HHD (p = .000), and SIS scores (p = .000), reflecting increased functional ability, grip strength, and improved quality of life.
Conclusion: The study confirmed the significant impact of hand grip strength on the functional independence and arm motor performance of stroke survivors, with Mirror Therapy providing substantial benefits. These findings advocate for the inclusion of grip strength-focused interventions and Mirror Therapy in stroke rehabilitation programs to improve survivors' functional outcomes and quality of life.
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References
Rauf R, Rashad A, Noreen A, Intikhab R, Suleman TA, Mughal S. COMPARISON OF MIRROR THERAPY AND MOTOR RELEARNING PROGRAM IN IMPROVING THE UPPER LIMB MOTOR FUNCTION OF PATIENTS WITH STROKE. Pakistan Armed Forces Medical Journal. 2021;71 (4):1364-67.
O'Sullivan SB, Schmitz TJ, Fulk G. Physical rehabilitation: FA Davis; 2019.
Smyth C, Broderick P, Lynch P, Clark H, Monaghan K. To assess the effects of cross-education on strength and motor function in post stroke rehabilitation: A systematic literature review and meta-analysis. Physiotherapy. 2023.
Nogueira NGdHM, Parma JO, de Assis Leão SES, de Souza Sales I, Macedo LC, Galvão ACDR, et al. Mirror therapy in upper limb motor recovery and activities of daily living, and its neural correlates in stroke individuals: a systematic review and meta-analysis. Brain Research Bulletin. 2021;177:217-38.
Schwarz A, Bhagubai MM, Wolterink G, Held JP, Luft AR, Veltink PH. Assessment of upper limb movement impairments after stroke using wearable inertial sensing. Sensors. 2020;20 (17):4770.
de Carvalho MS, Oliveira LHS. Effectiveness of mirror therapy by Fugl-Meyer scale in stroke: review with meta-analysis. Seven Editora. 2023:73-85.
Esponilla S. Mirror Therapy and Electrical Stimulation VS. Electrical Stimulation on Hand Function and Dexterity During Subacute Stroke Recovery: California State University, Fresno; 2022.
Bello UM, Kranz GS, Winser SJ, Chan CCH. Neural Processes Underlying Mirror-Induced Visual Illusion: An Activation Likelihood Estimation Meta-Analysis. Frontiers in Human Neuroscience. 2020;14.
Lin C-W, Kuo L-C, Lin Y-C, Su F-C, Lin Y-A, Hsu H-Y. Development and testing of a virtual reality mirror therapy system for the sensorimotor performance of upper extremity: A pilot randomized controlled trial. IEEE Access. 2021;9:14725-34.
Gandhi DB, Sterba A, Khatter H, Pandian JD. Mirror therapy in stroke rehabilitation: current perspectives. Therapeutics and clinical risk management. 2020:75-85.
Karamat S, Saeed A, Khan FM, Tariq A. EFFECT OF MIRROR THERAPY VERSUS REPETITIVE FACILITATION EXERCISE ON UPPER LIMB FUNCTION IN POST STROKE PATIENT. The Rehabilitation Journal. 2022;6 (02):351-6.
Hambir S, Satralkar A. Effectiveness of Movement Based Mirror Therapy Versus Task Based Mirror Therapy on Upper Limb Function, Muscle Tone and Grip Strength in Patients with Stroke: A Comparative Study. stroke.3:4.
Klinkwan P, Kongmaroeng C, Muengtaweepongsa S, Limtrakarn W. The effectiveness of mirror therapy to upper extremity rehabilitation in acute stroke patients. Applied Science and Engineering Progress. 2021.
Wen X, Li L, Li X, Zha H, Liu Z, Peng Y, et al. Therapeutic Role of Additional Mirror Therapy on the Recovery of Upper Extremity Motor Function after Stroke: A Single-Blind, Randomized Controlled Trial. Neural Plasticity. 2022;2022.
Kharka M, Singh P. A Study to Compare the Effectiveness of Mirror Therapy and Neuromuscular Electrical Stimulation on Upper-Extremity Motor Recovery, Motor Function, and Quality of Life in Subacute Stroke Subjects: A Randomized Controlled Trial. Medical Journal of Dr DY Patil University. 2021;14 (3):318-26.
Lundquist CB, Nguyen BT, Hvidt TB, Stabel HH, Christensen JR, Brunner I. Changes in upper limb capacity and performance in the early and late subacute phase after stroke. Journal of Stroke and Cerebrovascular Diseases. 2022;31 (8):106590.
Shaker H, Fahmy EM, Honin AAN, Mohamed SS. Effect of mirror therapy on hand functions in Egyptian chronic stroke patients. The Egyptian Journal of Neurology, Psychiatry and Neurosurgery. 2020;56 (1):1-6.
Maenza C, Wagstaff DA, Varghese R, Winstein C, Good DC, Sainburg RL. Remedial training of the less-impaired arm in chronic stroke survivors with moderate to severe upper-extremity paresis improves functional independence: a pilot study. Frontiers in Human Neuroscience. 2021;15:645714.
Gonzalez-Santos J, Soto-Camara R, Rodriguez-Fernández P, Jimenez-Barrios M, Gonzalez-Bernal J, Collazo-Riobo C, et al. Effects of home-based mirror therapy and cognitive therapeutic exercise on the improvement of the upper extremity functions in patients with severe hemiparesis after a stroke: A protocol for a pilot randomised clinical trial. BMJ open. 2020;10 (9):e035768.
Zlatičanin R, Jaganjac A, Hadžiomerović AM, Bojičić S, Katana B, Kraljević B, et al. MIRROR THERAPY IN THE REHABILITATION OF PERSONS AFTER STROKE. KNOWLEDGE-International Journal. 2023;58 (4):539-44.
Zhang Y, Xing Y, Li C, Hua Y, Hu J, Wang Y, et al. Mirror therapy for unilateral neglect after stroke: A systematic review. European Journal of Neurology. 2022;29 (1):358-71.