Factors impacting the real-world paretic hand use after stroke: A scoping review

Objective(s): To determine factors that impact real-world paretic hand use among stroke survivors

Data Sources: We searched Ovid Medline, Embase.com, Ovid APA PsycINFO, and the Physiotherapy Evidence Databases for articles in the English language and from 2012.

Study Selection: Out of 774 studies, we included 26 studies where participants were at least 18 years of age, exhibiting upper limb impairments after a stroke, real-world paretic hand use was objectively measured using a movement sensor such as an accelerometer, and factors affecting real-world paretic hand use were measured. Two reviewers screened the abstracts independently and consulted with a third reviewer to achieve consensus when there was a conflict in screening the studies. Level II screening of full-text studies and data extraction were conducted by the primary author.

Data Extraction: Data were extracted by the primary author based on the inclusion criteria.

Data Synthesis: The studies were categorized into observational, interventional, and secondary analysis studies. The results were categorized using the domains of the international classification of functioning, disability, and health namely, (1) body structures and function: cognitive, psychological, upper extremity (UE) impairment, and neurophysiological factors (2) activity and participation: task type, physical activity, UE function, and level of functional independence (3) environment: family support and caregiver presence (4) personal factors: age, gender, self-efficacy, and hand dominance. The data also included stroke-related factors.

Conclusions: UE impairment, UE function, level of functional independence, task type, hand dominance, and perception of paretic hand use were the prominent factors. Incorporating these factors while designing rehabilitation interventions may enhance real-world hand use after stroke.

Author(s) Disclosures: The authors have no conflicts of interest to disclose