Why don’t people regain use of arm and hand after stroke?
Answer
Fifty percent of stroke patients do not regain arm and hand function on their affected side. There are many reasons why arm and hand function is not regained after a stroke.
Arm use is often thought of as end-use dependent.
It is not necessary to use both arms to function.
Often as OTs, we teach our clients one-handed techniques to complete ADL tasks such as: dressing, sock donning, toothbrush preparation, adjusting clothing for toileting, shoe tying and buttoning. Therapy services often are very limited.
Therapy services are often very limited.
Improved hand movement does not always translate to improved hand use.
Patients are often not patient enough to continue trying to use affected arm and hand.
Therapists lack an effective toolkit to aggressively address arm and hand function.
Mary Harley, OT/L
Mary Harley is a research occupational therapist at MetroHealth Medical Center in Cleveland, Ohio. For the last 11 years, she has assisted in the design and implementation of NIH-sponsored randomized clinical trials studying functional electrical stimulation after stroke and has co-authored several papers on this topic. She is currently working on studies in contralaterally controlled functional electrical stimulation (CCFES) for upper limb recovery after stroke.
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