Speed of Finger Tapping as a Predictor of Functional Outcome After Unilateral Stroke

Hubbard

The Scientific World Journal

2013

Objective. Neurological dysfunction commonly occurs in the upper limb contralateral to the hemisphere of the brain in which stroke occurs; however, the impact of stroke on function of the ipsilesional upper limb is not well understood. This study aims to systematically review the literature relating to the function of the ipsilesional upper limb following stroke and answer the following research question: Is the ipsilesional upper limb affected by stroke? Data Source. A systematic review was carried out in Medline, Embase, and PubMed. Review Methods. All studies investigating the ipsilesional upper limb following stroke were included and analysed for important characteristics. Outcomes were extracted and summarised. Results. This review captured 27 articles that met the inclusion criteria. All studies provided evidence that the ipsilesional upper limb can be affected following stroke. Conclusion. These findings demonstrate that clinicians should consider ipsilesional upper limb deficits in rehabilitation and address this reduced functional capacity. Furthermore, the ipsilesional upper limb should not be used as a “control” measure of recovery for the contralateral upper limb.

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

The Ipsilesional Upper Limb Can Be Affected following Stroke

Hubbard

The Scientific World Journal

2013

“…Normal finger tapping requires the functional integrity of the corticospinal tract, cerebellar motor circuitry, and proprioceptive pathways [3]. Tasks involving the tapping of fingers, with varying techniques, have been widely studied in various domains such as neuropsychiatry and behavioral neurology (as a predictor of IQ and reaction time) [4, 5], traumatic brain injury and stroke (as an indicator of motor recovery) [6, 7], and perhaps most commonly in Parkinsonism (as an index of bradykinesia and hypokinesia) [8]. Upper extremity dysfunction has been reported in up to 80% of patients with multiple sclerosis (MS), the most common demyelinating disease of the central nervous system (CNS) [9].…”

Section: Introductionmentioning

confidence: 99%

Finger tapping impairments are highly sensitive for evaluating upper motor neuron lesions

2017

BackgroundIdentifying highly sensitive and reliable neurological exam components are crucial in recognizing clinical deficiencies. This study aimed to investigate finger tapping performance differences between patients with CNS demyelinating lesions and healthy control subjects.MethodsTwenty-three patients with multiple sclerosis or clinically isolated syndrome with infratentorial and/or cervical cord lesions on MRI, and 12 healthy controls were videotaped while tapping the tip of the index finger against the tip and distal crease of the thumb using both the dominant and non-dominant hand. Videos were assessed independently by 10 evaluators (three MS neurologists, four neurology residents, three advanced practice providers). Sensitivity and inter-evaluator reliability of finger tapping interpretations were calculated.ResultsA total of 1400 evaluations (four videos per each of the 35 subjects evaluated by 10 independent providers) were obtained. Impairments in finger tapping against the distal thumb crease of the non-dominant hand, identified by neurologists, had the greatest sensitivity (84%, p < 0.001) for detecting impairment. Finger tapping against the thumb crease was more sensitive than the thumb tip across all categories of providers. The best inter-evaluator reliability was associated with neurologists’ evaluations for the thumb crease of the non-dominant hand (kappa = 0.83, p < 0.001).ConclusionsImpaired finger tapping against the distal thumb crease of the non-dominant hand was a more sensitive technique for detecting impairments related to CNS demyelinating lesions. Our findings highlight the importance of precise examinations of the non-dominant side where impaired fine motor control secondary to an upper motor injury might be detectable earlier than the dominant side.

“…The FTT has been extensively utilized for assessing the clinical course and prognosis in patients with ataxia, acute stroke, alcoholic Korsakoff's syndrome, and Alzheimer disease 4) . For example, one study among patients with stroke reported that speed of finger tapping correlates with scores of the Barthel Index and the Frenchay Activities Index 5) , while another study demonstrated that healthy older adults show significantly slower tapping rates than young adults 6) . In addition, the variability of the intertap intervals and frequency of delayed taps increase with age, and these changes cannot be explained simply by grip strength and tactile sensitivity of the fingertips 7) .…”

Section: Introductionmentioning

confidence: 99%

Finger Tap Reaction Time as an Independent Prognostic Factor for Functional Outcome in Older Adults

Shim

Kim

Lim

et al. 2017

Ann Geriatr Med Res

Background: Decline in physical performance has been established as a risk factor for mortality and disability in older adults. Although previous studies have reported the age-related changes in finger-tapping ability, no study has been published describing the prognostic implications of finger tap reaction time among community-dwelling older adults. Methods: A total of 433 participants (227 men and 206 women) aged over 65 years were enrolled in the Korean Longitudinal Study on Health and Aging. According to the finger tap reaction time, participants were divided into 2 groups: a fast-reaction group and a slow-reaction group. We analyzed the interaction between delay in motor speed measured using the finger-tapping task and 5-year poor functional outcome, defined as short physical performance battery (SPPB) scores of 9 or less or mortality, during the follow-up period. Results: A significant increase in the risk of poor functional outcome was observed in the slow-reaction group, compared with in the fast-reaction group, even after covariate adjustment using multiple logistic regression analysis (odds ratio, 2.21; 95% confidence interval, 1.37-3.58). Conclusion: We conclude that delayed finger tap reaction time is an independent prognostic factor for poor functional outcome in older adults.