Week 5 EBP article: E. Gaylor

A study published in 1983 in The American Journal of Occupational Therapy examined the effects of 5 different exercises on finger extension of CVA patients.  Ten post-CVA patients were recruited for the study from the outpatient population of Braintree Hospital, in Braintree, Massachusetts.  The five exercises that were used were resisted grasp, resisted extension, rapid extension, unresisted slow extension, and unresisted grasp/release.  Electromyography of the extrinsic finger muscles and electrogoniometry of the wrist and finger joints were used to measure motor unit recruitment and ROM. 

The results showed that resisted and rapid exercises recruited the highest percentages of output of the extensor digitorum, flexor digitorum profundus, and the flexor digitorum superficialis.  Slow, unresisted exercises preferentially recruited the extensor digitorum.  None of the exercises caused immediate significant changes in ROM flexor/extension balance, time required to open the hand, or level of activity of the extensor digitorum during the opening of the hand.  Resisted grasp did not limit finger extension. 

The original hypothesis that resisted extension would recruit the highest level of motor output of the extensor digitorum than any of the other exercises was not supported by the data.  Higher levels were seen during resisted grasp and rapid, unresisted extension.  The use of slow, unresisted extensor activity or release of large objects selectively recruited the extensor digitorum over the flexor muscles the most. 

                                                                                                                           

Trombly, C. A., & Quintana, L. A. (1983). The Effects of Exercise on Finger Extension of CVA Patients. American Journal of Occupational Therapy, 37(3), 195-202. doi:10.5014/ajot.37.3.195

Article