Speed of finger tapping and goal attainment after unilateral cerebral vascular accident

Objective: To determine (1) if speed of finger tapping is bilaterally slow after an acute unilateral cerebral vascular accident (CVA) and (2) if speed of finger tapping and grip strength are related to achieving rehabilitation goals during the first few weeks after stroke. Design: Prospective inception cohort study. Study Setting: Medical center and neurological institute. Participants: Fifty-one patients with unilateral CVAs. Main Outcome Measures: Documentation of goal attainment at discharge and bilateral measures of speed of finger tapping and grip strength. Results: Speed of finger tapping and grip strength were often bilaterally below normal limits after an acute unilateral CVA, with the contralateral hand most affected. Speed of finger tapping, but not grip strength, in the ipsilateral hand was associated with achieving rehabilitation goals. Speed of finger tapping in the contralateral hand as well as bilateral grip strength was not related to achievement of rehabilitation goals. Conclusions: Motor findings suggest that bilateral cerebral dysfunction may be common after an acute unilateral CVA. The speed of finger movement in the hand ipsilateral to the lesion may reflect the degree to which the so-called ''unaffected'' cerebral hemisphere has in fact maintained its functional integrity. As such, it may be a useful behavioral marker for predicting goal attainment during early stages of neurorehabilitation. (C) 1997 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.