Self-perceived utilisation of the paretic arm in chronic stroke requires high upper limb functional ability

TY - JOUR

T1 - Self-perceived utilisation of the paretic arm in chronic stroke requires high upper limb functional ability

AU - Fleming, Melanie

AU - Newham, Dianne

AU - Roberts-Lewis, Sarah

AU - Sorinola, Isaac

PY - 2014

Y1 - 2014

N2 - OBJECTIVE: To explore potential predictors of self-reported paretic arm use at baseline and after task specific training (TST) in stroke survivors.DESIGN: Data were obtained from a randomised controlled trial of somatosensory stimulation and upper limb TST in chronic stroke.SETTING: University Laboratory.PARTICIPANTS: Thirty-three chronic (≥ 3 months) stroke survivors (mean age 62 years, mean stroke duration 38 months).INTERVENTIONS: Participants received 12 sessions of TST, preceded by either active (n = 16) or sham (n = 17) somatosensory stimulation to all three peripheral nerves.MAIN OUTCOME MEASURES: Demographic and clinical characteristics were entered stepwise into multiple linear regression analyses to determine the factors best predicting baseline Motor Activity Log (MAL) amount of use rating and change 3 months following TST.RESULTS: Action Research Arm Test (ARAT) score predicted amount of use at baseline (R2 = 0.47, p < 0.001) and using this model an ARAT score of 54 (max 57) is required to score 2.5 on the MAL (use described as between rarely and sometimes). Following TST the change in ARAT predicted change in amount of use (R2 = 0.31, p = 0.001). The predictive power of the model for change at 3 months was increased if Fugl-Meyer wrist component score was added (R2 = 0.41, p = 0.001).CONCLUSIONS: Utilisation of the paretic upper limb in activities of daily living requires high functional ability. The increase in self reported arm use following TST is dependent on the change in functional ability. These results provide further guidance for rehabilitation decisions.

AB - OBJECTIVE: To explore potential predictors of self-reported paretic arm use at baseline and after task specific training (TST) in stroke survivors.DESIGN: Data were obtained from a randomised controlled trial of somatosensory stimulation and upper limb TST in chronic stroke.SETTING: University Laboratory.PARTICIPANTS: Thirty-three chronic (≥ 3 months) stroke survivors (mean age 62 years, mean stroke duration 38 months).INTERVENTIONS: Participants received 12 sessions of TST, preceded by either active (n = 16) or sham (n = 17) somatosensory stimulation to all three peripheral nerves.MAIN OUTCOME MEASURES: Demographic and clinical characteristics were entered stepwise into multiple linear regression analyses to determine the factors best predicting baseline Motor Activity Log (MAL) amount of use rating and change 3 months following TST.RESULTS: Action Research Arm Test (ARAT) score predicted amount of use at baseline (R2 = 0.47, p < 0.001) and using this model an ARAT score of 54 (max 57) is required to score 2.5 on the MAL (use described as between rarely and sometimes). Following TST the change in ARAT predicted change in amount of use (R2 = 0.31, p = 0.001). The predictive power of the model for change at 3 months was increased if Fugl-Meyer wrist component score was added (R2 = 0.41, p = 0.001).CONCLUSIONS: Utilisation of the paretic upper limb in activities of daily living requires high functional ability. The increase in self reported arm use following TST is dependent on the change in functional ability. These results provide further guidance for rehabilitation decisions.

KW - ARAT, CIMT, FUGL MEYER, MOTOR ACTIVITY LOG, RANDOMISED CONTROLLED TRIAL, SOMATOSENSORY STIMULATION

U2 - 10.1016/j.apmr.2014.01.009

DO - 10.1016/j.apmr.2014.01.009

M3 - Article

SN - 0003-9993

VL - 95

SP - 918

EP - 924

JO - Archives of Physical Medicine and Rehabilitation

JF - Archives of Physical Medicine and Rehabilitation

IS - 5

ER -