Background-Knowing how clinical tests are related to each other, if tests are responsive to change and what constitutes change is critical to evidence-based practice and sound research.

These data support the idea that loss of movement control covaries across segments and that loss of hand function is due to loss of movement control at all segments, not just at distal ones.

Background and Purpose-After stroke, 80% of patients experience acute paresis of the upper extremity and only approximately one-third achieve full functional recovery. Predicting functional recovery for these patients is highly important to provide focused, cost-effective rehabilitation. Our purpose was to examine if early measures of upper extremity active range of motion (AROM) could predict recovery of upper extremity function, and to describe the trajectory of upper extremity AROM recovery over time. Methods-Thirty-three subjects were tested at 1 month and then at 3 months after stroke. Upper extremity function was measured with 6 standardized clinical tests that were synthesized into a single, sensitive score for upper extremity function using principal component analysis. The ability to move each segment (AROM) was measured using a 3-dimensional electromagnetic tracking system. Results-Stepwise multiple regression revealed that AROM of the shoulder and middle finger segments taken at 1 month could predict 71% of the variance in upper extremity function at 3 months. All segments of the upper extremity recover similarly and no evidence of a proximal to distal gradient in motor deficits appeared over time. Conclusions-Simple AROM measurements of the upper extremity taken within 1 month after stroke can be used to predict upper extremity function at 3 months. This information is important for determining the prognosis of upper extremity functional recovery.

Study Design: Single-group repeated-measures design. Objectives: To investigate the ability of the wall slide exercise to activate the serratus anterior muscle (SA) at and above 90°of humeral elevation. Background: Strengthening of the SA is a critical component of rehabilitation for patients with shoulder impingement syndromes. Traditional SA exercises have included scapular protraction exercises such as the push-up plus. These exercises promote activation of the SA near 90°of humeral elevation, but not in positions above 90°where patients typically experience pain. Methods and Measures: Twenty healthy subjects were studied performing 3 exercises: (1) wall slide, (2) plus phase of a wall push-up plus, and (3) scapular plane shoulder elevation. Three-dimensional position of the thorax, scapula, and humerus and muscle activity from the SA, upper and lower trapezius, and latissimus dorsi were recorded. The magnitudes of activation for each muscle at 90°, 120°, and 140°of humeral elevation were quantified from EMG records. Repeated-measures analyses of variance were used to determine the degree to which the different exercises activated the SA at the 3 humeral positions. Results: The intensity of SA activity was not significantly different between the 3 exercises at 90°o f humeral elevation (P = .40). For the wall slide and scapular plane shoulder elevation exercises, SA activity increased with increasing humeral elevation angle (P = .001), with no significant differences between the 2 exercises (P = .36). Conclusion:The wall slide is an effective exercise to activate the SA muscle at and above 90°of shoulder elevation. During this exercise, SA activation is not significantly different from SA activation during the push-up plus and scapular plane shoulder elevation, 2 exercises previously validated in the literature.