Does grip strength of the less-affected side of ischemic stroke survivors influences performance of self-care activities?

Abstract

Background and aim: Adequate grip strength is needed to execute various self-care activities. This study was aimed to assess the influence of grip strength of the less-affected side of ischemic stroke survivors on performance of self-care activities, and also to determine the reference values of less-affected grip strength needed for independent performance of each of the self-care activities. Methods: Seventy-three consenting patients with ischemic stroke participated in this cross-sectional study. Hand-held dynamometer was used to measure grip strength of the less-affected hand, while functional independence measure was used to evaluate self-care activities (eating, grooming, bathing, dressing of upper body, dressing of lower body and toileting) as independent and dependent. Data was analyzed using inferential statistics of Pearson's correlation, binomial logistic regression, and receiver operating characteristics. Alpha level was set at p < 0.05. Results: The mean hand grip strength, functional independence measure and trunk control test scores were 23.8 kg, 29.9 kg, and 68.2 kg respectively. Grip strength was significantly associated with independence in all of the self-care activities (p < 0.05). Less-affected grip strength of 19.5 kg (sensitivity, 80.4%; specificity, 80.1%; area under curve, 0.85), 23.7 kg (sensitivity, 79%; specificity, 72.2%; area under curve, 0.79), 24.8 kg (sensitivity, 70.2%; specificity, 65.2%; area under curve, 0.75), 24.7 kg (sensitivity, 82.1%; specificity, 80.1%; area under curve, 0.84), 23.7 kg (sensitivity, 80.1%; specificity, 76.1%; area under curve, 0.84), and 19.9 kg (sensitivity, 76.9%; specificity, 76.2%; area under curve, 0.79) was needed for independent performance in eating, grooming, bathing, dressing of upper body, dressing of lower body, and toileting respectively. Conclusion: The less-affected grip strength of patients with ischemic stroke influences their ability to independently perform self-care activities. The reference values of less-affected grip strength in association with other stroke-related characteristics may help clinicians to estimate independence in eating, grooming, bathing, dressing of upper body, dressing of lower body, and toileting among patients with ischemic stroke.