The FMA-UE was successfully translated into Danish. An MCID ≥ 4 was found. This study provides evidence that the FMA-UE is a reliable, responsive and valid instrument for measuring upper limb impairment after stroke. Implications for rehabilitation One of the most widely recognized measures of upper extremity motor impairment post-stroke is the Fugl-Meyer Assessment of the Upper Extremity (FMA-UE). The psychometric properties of a measurement depends on the population and setting in which it is used. In this study, the FMA-UE is translated into Danish and the psychometric properties of FMA-UE is determined in a Danish population of patients with stroke. The FMA-UE is now available to use for clinicians in Denmark.
Background In recent years, virtual reality (VR) therapy systems for upper limb training after stroke have been increasingly used in clinical practice. Therapy systems employing VR technology can enhance the intensity of training and can also boost patients' motivation by adding a playful element to therapy. However, reports on user experiences are still scarce. Methods A qualitative investigation of patients' and therapists' perspectives on VR upper limb training. Semistructured face-to-face interviews were conducted with six patients in the final week of the VR intervention. Therapists participated in two focus group interviews after the completion of the intervention. The interviews were analyzed from a phenomenological perspective emphasizing the participants' perceptions and interpretations. Results Five key themes were identified from the patients' perspectives: (i) motivational factors, (ii) engagement, (iii) perceived improvements, (iv) individualization, and (v) device malfunction. The health professionals described the same themes as the patients but less positively, emphasizing negative technical challenges. Conclusion Patients and therapists mainly valued the intensive and motivational character of VR training. The playful nature of the training appeared to have a significant influence on the patients' moods and engagement and seemed to promote a “gung-ho” spirit, so they felt that they could perform more repetitions.
Background The Predict Recovery Potential algorithm (PREP2) was developed to predict upper limb (UL) function early after stroke. However, assessment in the acute phase is not always possible. Objective To assess the prognostic accuracy of the PREP2 when applied in a subacute neurorehabilitation setting. Methods This prospective longitudinal study included patients ≥18 years old with UL impairment following stroke. Patients were assessed in accordance with the PREP2 approach. However, 2 main components, the shoulder abduction finger extension (SAFE) score and motor-evoked potentials (MEPs) were obtained 2 weeks poststroke. UL function at 3 months was predicted in 1 of 4 categories and compared with the actual outcome at 3 months as assessed by the Action Research Arm Test. The prediction accuracy of the PREP2 was quantified using the correct classification rate (CCR). Results Ninety-one patients were included. Overall CCR of the PREP2 was 60% (95% CI 50%-71%). Within the 4 categories, CCR ranged from the lowest value at 33% (95% CI 4%-85%) for the category Limited to the highest value at 78% (95% CI 43%-95%) for the category Poor. In the present study, the overall CCR was significantly lower ( P < .001) than the 75% reported by the PREP2 developers. Conclusions The low overall CCR makes PREP2 obtained 2 weeks poststroke unsuited for clinical implementation. However, PREP2 may be used to predict either excellent UL function in already well-recovered patients or poor UL function in patients with persistent severe UL paresis.
Left/right judgement does not influence the effect of MT. There seems to be no reason to test the ability to perform left/right judgement before the onset of MT. MT is an intervention without major adverse effects. Implications for Rehabilitation Mirror therapy (MT) is a method for treating sensory and motor disturbances post-stroke. It is important to clarify whether the ability to perform left/right judgement influences the effect of MT. In this study, left/right judgement does not influence the effect of MT. Based on the results of this study, testing and training left/right judgement before commencing MT cannot be recommended.
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