Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Feb;38(2):134-147.
doi: 10.1177/15459683241227222. Epub 2024 Jan 25.

Patient Outcomes After Peripheral Nerve Injury Depend on Bimanual Dexterity and Preserved Use of the Affected Hand

Taewon Kim  1 , Keith R Lohse  2 , Susan E Mackinnon  3 , Benjamin A Philip  1
Affiliations

Patient Outcomes After Peripheral Nerve Injury Depend on Bimanual Dexterity and Preserved Use of the Affected Hand

Taewon Kim et al. Neurorehabil Neural Repair. 2024 Feb.

Abstract

Background: Little is known about how peripheral nerve injury affects human performance, behavior, and life. Hand use choices are important for rehabilitation after unilateral impairment, but rarely measured, and are not changed by the normal course of rehabilitation and daily life.

Objective: To identify the relationship between hand use (L/R choices), motor performance, and patient-centered outcomes.

Methods: Participants (n = 48) with unilateral peripheral nerve injury were assessed for hand use via Block Building Task, Motor Activity Log, and Edinburgh Handedness Inventory; dexterity (separately for each hand) via Nine-Hole Peg Test, Jebsen Taylor Hand Function Test, and a precision drawing task; patient-centered outcomes via surveys of disability, activity participation, and health-related quality of life; and injury-related factors including injury cause and affected nerve. Factor Analysis of Mixed Data was used to explore relationships between these variables. The data were analyzed under 2 approaches: comparing dominant hand (DH) versus non-dominant hand (NH), or affected versus unaffected hand.

Results: The data were best explained by 5 dimensions. Good patient outcomes were associated with NH performance, DH performance (separately and secondarily to NH performance), and preserved function and use of the affected hand; whereas poor patient outcomes were associated with preserved but unused function of the affected hand.

Conclusion: After unilateral peripheral nerve injury, hand function, hand usage, and patient life arise from a complex interaction of many factors. To optimize rehabilitation after unilateral impairment, new rehabilitation methods are needed to promote performance and use with the NH, as well as the injured hand.

Keywords: hand dominance; lateralization; manual dexterity; peripheral nerve injury; quality of life.

PubMed Disclaimer

Conflict of interest statement

Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Dr. Philip and Washington University in St. Louis have a licensing agreement with PlatformSTL to commercialize the precision drawing task used in this study.

Figures

Figure 1:
Figure 1:
Precision Drawing Task. Five sample stimuli shown, out of 45 possible.
Figure 2:
Figure 2:
Factor Analysis of Mixed Data results from DH/NH approach. A: Scree plot showing all dimensions with eigenvalues ≥ 1.0 (9/30 dimensions). Numbers are: eigenvalue (% variance explained). B-F: factor loadings for the five dimensions with eigenvalue ≥ 2.0.
Figure 3:
Figure 3:
Factor Analysis of Mixed Data results from AH/UH approach. A: Scree plot showing all dimensions with eigenvalues ≥ 1.0 (10/30 dimensions). Numbers are: eigenvalue (% variance explained). B-F: factor loadings for the five dimensions with eigenvalue ≥ 2.0.
Figure 4:
Figure 4:
Correlograms of linear relationships between all variables. For visual clarity, variables are ordered to show positive correlations between nearby variables. A: DH/NH approach. B: AH/UH approach.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Foerch C, Misselwitz B, Sitzer M, Berger K, Steinmetz H, Neumann-Haefelin T. Difference in recognition of right and left hemispheric stroke. The Lancet. 2005;366(9483):392–393. - PubMed
    1. Mani S, Mutha PK, Przybyla A, Haaland KY, Good DC, Sainburg RL. Contralesional motor deficits after unilateral stroke reflect hemisphere-specific control mechanisms. Brain. 2013;136(4):1288–1303. - PMC - PubMed
    1. Hedna VS, Bodhit AN, Ansari S, et al. Hemispheric differences in ischemic stroke: is left-hemisphere stroke more common? Journal of Clinical Neurology. 2013;9(2):97–102. - PMC - PubMed
    1. Stonner MM, Mackinnon SE, Kaskutas V. Predictors of Disability and Quality of Life After Nerve Injury. American Journal of Occupational Therapy. 2017;71(1):7101190050p1–7101190050p8. - PubMed
    1. Brattain K Analysis of the Peripheral Nerve Repair Market in the United States. 2013.