Poststroke hand swelling and oedema: prevalence and relationship with impairment and disability

Objective: To examine the prevalence of swelling and oedema of the hand in stroke patients and relationships with impairments and disability. Design: Cross-sectional. Setting: Stroke unit at Rehabilitation Centre De Hoogstraat, the Netherlands. Subjects: Eighty-eight adult stroke patients who were admitted for clinical rehabilitation during one year (2000). Measurements and methods: Assessment took place two weeks after admission to the rehabilitation centre. Degree of swelling was measured with a hand volumeter and oedema was defined as a volumeter score deviating more than two standard deviations from the expected score derived from population data. Further assessment included tonus (Modified Ashworth Score), sensibility, tactile inattention, carefulness, and motor function (Utrecht Arm/Hand Test). Arm disability was measured with Frenchay Arm Test and Nine-hole Peg Test. Results: Some degree of hand swelling was present in 72.7% and oedema in 33.0% of our patients. Swelling and oedema were significantly more often seen in patients with hypertonic fingers and impaired sensibility. Patients with hand oedema had significantly worse Frenchay Arm Test and Nine-hole Peg Test scores. Conclusions: Swelling and oedema of the hand are common among stroke patients in clinical rehabilitation.