Summary

Upper-limb speed and dexterity are frequently impaired after moderate or severe traumatic brain injury (TBI). The speed of functional hand movements can be assessed with standardized tasks, such as the Developmental Hand Function Test and the Purdue Pegboard test. Kinematic data on reaching and grasping can be obtained by optoelectronic motion analyses. The fingertip forces measured during a precision grip–lift task describe fine motor control. With these methods, a series of studies analyzed recovery of hand function in brain-injured children and adolescents (age 4–15 years) over 5 months of inpatient rehabilitation, starting ∼3 months post TBI. Compared with healthy age-matched controls, the patients were slower, their prehension movements exhibited curved and variable movement trajectories, and were delayed especially in the final approach phase. They needed more time to establish a precision grip and showed exaggeratedly high grip forces. Despite substantial recovery, differences in hand function between patients and controls were still present ∼8 months after TBI. Young age at injury was not associated with better recovery. Comparable data for adults are lacking so far.

Traumatic brain injury: incidence, severity and imaging

The annual incidence of traumatic brain injury (TBI) in Germany is about 300 per 100,000 inhabitants (Federal Statistical Office, www.destatis.de). Epidemiological studies from other countries report incidences of ∼200–500/100,000 per year; these variations reflect different inclusion criteria and study designs (Hillier et al., 1997; Servadei et al., 2002; Andersson et al., 2003). Common causes of TBI are traffic accidents, falls and sport-related accidents.