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Protocol for Assessment of Post Stroke Hemiplegic Patient: Hand (C)

Purpose: To evaluate the hand of a post-stroke hemiplegic patient as part of the protocol developed by Fugl-Meyer.

Description

Fugl-Meyer et al developed a protocol for physical and functional assessment of a hemiplegic patient following a stroke. The examination is divided into various sections, including examination of the hand. The authors are from the University of Goteborg in Sweden.


 

Hand evaluation:

(1) fingers mass flexion

(2) fingers mass extension (can release a flexion grasp)

(3) grasp with digits II to V

(4) grasp of thumb against second metacarpal using a piece of paper

(5) grasp of thumb and second finger about a pencil

(6) grasp about cylinder-shaped object (soda can, other)

(7) grasp about spherical object

 

Performance is compared between the affected and unaffected side.

 

Parameter

Finding

Points

fingers mass flexion

cannot be performed

0

 

suboptimal

1

 

adequately performed

2

fingers mass extension

cannot be performed

0

 

suboptimal

1

 

adequately performed

2

grasp digits II to V

cannot be performed

0

 

isuboptimal, weak

1

 

adequately performed

2

grasp thumb against second metacarpal

cannot be performed

0

 

suboptimal

1

 

adequately performed

2

grasp thumb and second finger about a pencil

cannot be performed

0

 

suboptimal

1

 

adequately performed

2

grasp about a cylindrical object

cannot be performed

0

 

suboptimal

1

 

adequately performed

2

grasp about a spherical object

cannot be performed

0

 

suboptimal

1

 

adequately performed

2

 

total subscore for the hand =

= SUM(points for all 7 assessments)

 

Interpretation:

• minimum score: 0

• maximum score: 14 (normal)

• The higher the score the greater the functional ability of the hand.

 


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Specialty

Objective

ICD-10