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Cognitive Function and Upper Limb Rehabilitation Training Post-Stroke Using a Digital Occupational Training System
Published on: December 29, 2023
Relationships between upper-limb functional limitation and self-reported disability 3 months after stroke
Alexander W Dromerick1, Catherine E Lang, Rebecca Birkenmeier
1Department of Neurology, and Programs, Washington University, St. Louis, MO, USA. alexander.w.dromerick@medstar.net
Journal of Rehabilitation Research and Development
|October 17, 2006
Summary
Even with excellent motor recovery after stroke, patients often report persistent disability. Functional tests may not capture the full impact on daily upper-limb use and task speed.
Area of Science:
- Neurorehabilitation
- Clinical Trials
- Stroke Recovery
Background:
- Upper-limb (UL) functional limitations and self-reported disability are key outcomes in stroke rehabilitation.
- Constraint-induced movement therapy (CIMT) is an early intervention strategy.
Purpose of the Study:
- To explore relationships between UL functional limitations and self-reported disability in stroke patients undergoing acute rehabilitation.
- To determine if excellent motor recovery on functional tests translates to restored everyday UL use.
Main Methods:
- Analysis of 39 stroke patients from the VECTORS (Very Early Constraint Treatment for Recovery from Stroke) pilot trial.
- Assessment at 90 days post-stroke using the Action Research Arm (ARA) test, Wolf Motor Function Test (WMFT), Functional Independence Measure (FIM), and Motor Activity Log (MAL).
Main Results:
- Patients with perfect or near-perfect scores on ARA or WMFT still reported residual disability on FIM and MAL.
- WMFT quality of movement was not strongly associated with self-reported frequency of use (MAL amount).
- WMFT speed of movement was not associated with self-reported frequency of use (MAL amount).
Conclusions:
- Perceived disability measures capture information not assessed by standard functional limitation and impairment scales.
- Excellent motor recovery on functional scales does not equate to restoration of everyday UL use.
- A comprehensive measurement strategy is needed to detect meaningful clinical improvements in early rehabilitation trials.
