THE ASSESSMENT OF THE EXTENT OF THE RECOVERY OF HAND SENSORIMOTOR FUNCTIONS IN THE GROUP OF REHABILITATED PATIENTS AFTER STROKE IN THE POST-ACUTE STAGE

摘要

BACKGROUND: Although the deficit of hand sensomotory functions is very common in patients after stroke, the algorithm of their renewal is relatively little known. It is not clear whether the extent or type of somatosensory dysfunction correlates with an impeded process of motorics renewal. OBJECTIVE: This study was focused on observation of hand sensorimotor functions in a group of patients in postacute phase after ischemic stroke, localized in artery cerebri media. The aim was to find out the extent of improvement of somatosensory and motor hand functions. This is the first stage of a research project which will be followed by the observation of an experimental group with therapy targeted to somatosensory functions. METHODS: The observed group of patients was treated at an inpatient department of a rehabilitation clinic and underwent standard therapy lasting 3 - 4 weeks. To assess hand sensorimotor functions two sensation tests were used: the FMT - the Fabric Matching Test and the RASP - The Rivermead Assessment of Somatosensory Performance. Two tests of fine motor function were also used: the NHPT - The Nine Hole Peg Test and the TMF - The Test of Manipulation Functions by means of a special constructional set Ministav. These tests were performed at the begin-ning and at the end of therapy. RESULTS: In the observed group of patients, we found impairments of somatosensory functions and fine motor function even on the unimpaired upper limb. Nevertheless, fine motor function is impaired more seriously than the somatosensory functions. The biggest de ficits of motor functions were found in tasks which had required a precise grip. The most obvious changes in the assessment of patients were found in ADL assessed by the Barthel Index - the return of functions towards the standard was observed in one third of the subjects. CONCLUSION: After the application of standard therapy, improvement of hand sensorimotor functions was observed in a group of patients, but the results are not consistent. Some of the patients got worse and sometimes there was only a slight change. The results of an experimental group of patients must be proven by a therapy specifically targeted to in fluence the somatosensory functions.