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6. Hand Problems resulting from stroke, cerebral palsy, or spinal cord injury

Hand Problems Resulting from Stroke, Cerebral Palsy, or Spinal Cord Injury

Hand problems resulting from stroke, cerebral palsy (CP), or spinal cord injury are due to an interruption of the normal nerve innervation of the muscles of the upper extremity. Stroke and CP may cause spasticity or overstimulation of some muscles. These muscles then overpower other muscles leading to a tightened position of a joint. While there are classic positions of stiffness, every patient is different. Spinal cord injury leads to muscle weakness and functional limitations.

We believe that to understand the functional difficulties of an individual with one of these problems, a careful conversation and a detailed physical examination must be undertaken. Once we understand the specific limitations of the patient, a treatment plan can be developed. Therapists are helpful in patient assessment and development of a treatment plan.

Treatment usually involves therapy to stretch the tight muscles and joints and strengthen the weaker muscles. Therapy can be helpful. If not ultimately successful, there may be a role of botulinum toxin injection to help with therapy. Finally, surgical releases and tendon transfer can be very helpful to rebalance the affect joint or extremity.