Perceived Facilitators and Barriers for Actual Arm Use during Everyday Activities in Community Dwelling Individuals with Chronic Stroke

Lebovich, Shir; Rand, Debbie

doi:10.3390/ijerph191811707

Cited by 5 publications

(7 citation statements)

References 44 publications

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“…The ultimate goal of this research is to improve actual arm use, defined as the spontaneous use of the affected UE in real world situations [ 67 ]. The results of this study will advance the scientific knowledge for UE rehabilitation because the use of MI and EMA as methods for enhancing adherence and engagement in UE self-training is a novel application.…”

Section: Discussionmentioning

confidence: 99%

Protocol for a remote home-based upper extremity self-training program for community-dwelling individuals after stroke

Gahlot¹,

Magsombol²,

Waskjewicz³

et al. 2023

Contemporary Clinical Trials Communications

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Section: Discussionmentioning

confidence: 99%

Protocol for a remote home-based upper extremity self-training program for community-dwelling individuals after stroke

Gahlot¹,

Magsombol²,

Waskjewicz³

et al. 2023

Contemporary Clinical Trials Communications

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“…Participants with PSD may have experienced decrease in active daily routines, and less energy to invest the extra (cognitive or physical) effort needed to use their affected UE in everyday activities, factors which have been reported to facilitate UE daily-use. 8 Since there were significant between-group differences at T3, we further categorized the participants into 4 subgroups to take into account participants with consistent PSD status and those who experienced changes in PSD status by T3. Participants who always had PSD or converted into PSD by T3 had the worst performance for all UE outcome measures compared to participants who never had PSD or converted out of PSD by T3.…”

Section: Discussionmentioning

confidence: 99%

“…7 Daily-use of the affected UE, also termed real-world use and actual arm use, is defined as the spontaneous integration and use of this UE in the real-world. 8 From the perspective of individuals with stroke, daily-use is considered the most important indicator for UE recovery. 9 Previous studies have identified motor and sensory deficits as key factors that contribute to daily-use of the affected UE.…”

Section: Introductionmentioning

confidence: 99%

“…9 Previous studies have identified motor and sensory deficits as key factors that contribute to daily-use of the affected UE. 10 Recent studies have expanded the literature and identified additional factors associated with daily-use including personal factors, environmental factors, and task characteristics, in chronic stroke, 8 as well as UE self-efficacy. 11 Post-stroke depression (PSD) is a common psychiatric personal factor present in about 30% of the individuals with stroke, including those with mild stroke.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of Upper Extremity Function and Daily Use in Individuals with and without Post Stroke Depression

Assadi Khalil,

Kim,

Rand

2023

Neurorehabil Neural Repair

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Background Post-stroke depression (PSD) is a frequent psychiatric complication, however very few studies have investigated its relation to the affected upper extremity (UE) post-stroke. Objective. To compare the affected UE in terms of motor impairment, functional ability, and daily-use in individuals with and without PSD during the first 6 months post-stroke. Methods This study analyzed data from a previous cohort; participants were assessed at rehabilitation admission (T1), 6 weeks (T2), and 6 months (T3) post-stroke. At each time point we compared between participants with and without PSD (Geriatric Depression Scale score ≥ 5). The Fugl-Meyer Motor Assessment assessed motor impairment, Action Research Arm Test assessed functional ability, and the Rating of Everyday Arm-Use in the Community and Home assessed daily-use. Independence in daily activities and cognition were also assessed. Results A total of 116 participants were recruited, 38% had PSD at T1. No significant differences were found between groups at T1 and T2. However, significant differences ( z = −5.23 to −2.66, p < .01) were found between groups for all UE measures at T3; participants with PSD had lower motor and functional ability and less daily hand-use than participants without PSD. At T3 participants with PSD were also less independent in daily-living. Conclusions PSD is associated with greater UE motor, functional, and daily-use disability at 6 months post-stroke. Our findings underscore the negative impact of PSD on UE during the crucial transition period when individuals return home and integrate back into the community. Further research is needed to delineate the effect of change in PSD status on UE outcomes post stroke.

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“…A weaker relationship between the FMA and the MAL-AOU (r s 0.35), but comparably high correlations for MAL-QOM (r s 0.76) were shown in a cross-sectional study including 223 individuals 89 . High variability of associations with perceived arm use may be related to the individual and cultural context 90 .…”

Section: Concurrent Validitymentioning

confidence: 99%

Concurrent Validity and Responsiveness of Clinical Upper Limb Outcome Measures and Sensor-based Arm Use Metrics within the First Year after Stroke: A Longitudinal Cohort Study

Pohl,

Verheyden,

Held

et al. 2024

Preprint

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Background: Concurrent validity and responsiveness of upper limb outcome measures are essential to interpret motor recovery poststroke. Evaluating the associations between clinical upper limb measures and sensor-based arm use (AU) fosters a comprehensive understanding of motor recovery. Defining sensor-based AU metrics for intentional upper limb movements could be crucial in mitigating bias arising from walking-related activities. Here, we investigate the measurement properties of a comprehensive set of clinical measures and sensor-based AU metrics when gait and non-functional upper limb movements are excluded. Methods: In a prospective, longitudinal cohort study, individuals with motor impairment were measured at days 3±2 (D3), 10±2 (D10), 28±4 (D28), 90±7 (D90), and 365±14 (D365) after their first stroke. Upper limb function, activity capacity, and performance were assessed using the Fugl-Meyer Assessment, Action Research Arm Test, Box & Block Test, and the 14-item Motor Activity Log. For three days, individuals wore five movement sensors (trunk, wrists, and ankles). Thirteen AU metrics were computed based on functional movements during non-walking periods. Concurrent validity across clinical and AU metrics was determined by Spearman's rank correlations for each time point. Criterion-based responsiveness was examined by correlating patient-reported Global Rating of Perceived Change (GRPC) scores (1-7) and observed change in upper limb outcome. Optimal cut-off values for minimal important change (MIC) were estimated by ROC curve analysis. Results: Ninety-three individuals participated. At D3 and D10, correlations between clinical measures and AU-metrics presented variability (range rs 0.44-0.90, p<0.01). All time points following showed strong positive associations between capacity measures and affected AU metrics (range rs 0.73-0.94, p<0.01), whereas unilateral nonaffected AU metrics had low-to-high negative associations (range rs 0.48-0.77). Responsiveness across outcomes was highest between D10-D28 within moderate-to-strong relations between GRPC and clinical measures (rs range 0.60-0.73, p<0.01), whereas relations were weaker for AU-metrics (rs range 0.28-0.43, p<0.05). Eight MIC values were estimated for clinical measures and nine for AU metrics, showing moderate to good accuracy (66-87%). Conclusions: We present reference data on concurrent validity and responsiveness of clinical upper limb measures and specified AU metrics within the first year poststroke. Estimated MIC values can be used as a benchmark for clinical stroke rehabilitation. Trial registration: This trial was registered on clinicaltrials.gov; registration number NCT03522519.

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Perceived Facilitators and Barriers for Actual Arm Use during Everyday Activities in Community Dwelling Individuals with Chronic Stroke

Cited by 5 publications

References 44 publications

Protocol for a remote home-based upper extremity self-training program for community-dwelling individuals after stroke

Protocol for a remote home-based upper extremity self-training program for community-dwelling individuals after stroke

Comparison of Upper Extremity Function and Daily Use in Individuals with and without Post Stroke Depression

Concurrent Validity and Responsiveness of Clinical Upper Limb Outcome Measures and Sensor-based Arm Use Metrics within the First Year after Stroke: A Longitudinal Cohort Study

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