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A new hand assessment instrument for severely affected stroke patients

Article type: Research Article

Authors: Broetz, Dorisa; * | Del Grosso, Nicholas A.a | Rea, Massimilianoa | Ramos-Murguialday, Andera; b | Soekadar, Surjo R.a; c | Birbaumer, Nielsa; d

Affiliations: [a] Institute of Medical Psychology and Behavioral Neurobiology, MEG Center, University of Tuebingen, Tuebingen, Germany | [b] Health Technologies Department, TECNALIA, San Sebastian, Spain | [c] Department of Psychiatry and Psychotherapy, University of Tuebingen, Tuebingen, Germany | [d] Ospedale San Camillo, Istituto di Ricovero e Cura a Curattere Scientifico, IRCCS, Venezia, Italy

Correspondence: [*] Address for correspondence: Doris Broetz, MEG Center, University of Tuebingen, Otfried-Mueller-Str. 47, 72076 Tuebingen, Germany. Tel.: +49 1631640558; E-mail: [email protected]

Keywords: Stroke, assessment, hand function, physiotherapy, rehabilitation

DOI: 10.3233/NRE-141063

Journal: NeuroRehabilitation, vol. 34, no. 3, pp. 409-427, 2014

Published: 26 June 2014
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Abstract

Background:

Standard assessment instruments cannot differentiate patients with minimal residual hand function after stroke. As a result, changes in motor recovery are difficult to document using currently-available tests. In a controlled study with chronic stroke patients without residual finger extension, a new hand function test has been developed. This instrument, called Broetz Hand Test (BzH), allows to assess small variations in hand function in severely paralyzed stoke patients. The instrument is easy to use, and was developed using principles of motor learning and behavioral assessment.

Methods:

The instrument consists of seven daily life-oriented tasks, each of which asks for movement of the paralyzed hand. BzH of 20 patients after stroke was evaluated before and after a behavioral physiotherapy treatment. Sensitivity, inter-observer reliability, test-retest reliability and construct validity was calculated.

Results:

Two-tailed paired-samples t-test before and after treatment demonstrated sufficient sensitivity. Mean agreement between the raters resulted in an excellent interrater-reliability. Test-retest reliability between the pre- and post-treatment scores was 0.9. The correlation between BzH and standard test scores was statistically significant and demonstrated sufficient validity.

Conclusion:

The BzH is a valid and reliable tool to assess changes in hand function in severely paralyzed patients after stroke.

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