Finger Extension and Tripod Grip as Indicators of Hand Function Improvement in Subacute Stroke Patients

Abstract

Background: Stroke is a leading cause of long-term disability globally, with persistent upper limb dysfunction significantly impairing independence in daily activities. Existing assessments such as the Fugl-Meyer Assessment emphasize gross motor recovery but may overlook fine motor skills essential for dexterous hand use. Identifying simple, reliable, low-cost indicators of hand function recovery could optimize rehabilitation strategies, particularly in resource-constrained settings. Objective: To evaluate whether finger extension range of motion and tripod grip ability independently predict hand function recovery and dexterity in patients with subacute stroke. Methods: This cross-sectional observational study included 120 patients aged 40–85 years with first-ever unilateral ischemic stroke within 2 weeks to 2 months post-onset. Finger extension was measured with a goniometer at MCP joints; tripod grip ability was scored ordinally. Outcomes included Fugl-Meyer Hand Section scores and Nine-Hole Peg Test times. Spearman’s correlations assessed associations between finger-specific measures and functional outcomes. Results: Finger extension, particularly at the index MCP joint (ρ = 0.67; p < 0.001), and tripod grip ability (ρ = 0.71; p < 0.001) were strongly associated with higher Fugl-Meyer scores. Both measures inversely correlated with Nine-Hole Peg Test times (tripod grip ρ = –0.69; p < 0.001). Patients with full tripod grip demonstrated significantly faster dexterity and greater motor recovery compared to those with partial or no grip ability. Conclusion: Finger extension and tripod grip are practical, robust predictors of motor recovery and dexterity in subacute stroke patients. Their routine clinical assessment may facilitate targeted rehabilitation and improve functional outcomes.