Comparison of three tools to measure improvements in upper-limb function with poststroke therapy

Area of Science:

• Neurorehabilitation
• Clinical Assessment
• Motor Recovery

Background:

• Post-stroke functional ability monitoring is crucial for recovery assessment and clinical trial evaluation.
• Multidomain tools are used to comprehensively assess upper-limb function, balancing implementation time and sensitivity.

Purpose of the Study:

• To evaluate the suitability of three common multidomain upper-limb assessment tools for patients with varying motor function levels post-stroke.
• To investigate the impact of patient stratification on assessment tool performance.

Main Methods:

• Forty-nine hemiparetic patients underwent a 14-day upper-limb rehabilitation program using Wii-based Movement Therapy.
• Assessments included the Fugl-Meyer Assessment (F-M), Wolf Motor Function Test (WMFT), and Motor Assessment Scale (MAS).
• Patients were stratified into low, moderate, and high motor-function groups.

Main Results:

• Significant upper-limb function improvement was observed in the pooled cohort across all tests (P < .001).
• Ceiling effects were noted for F-M, floor effects for WMFT, and both for MAS.
• Subgroup analysis revealed differential test sensitivity based on motor function levels.

Conclusions:

• No single assessment tool is universally suitable for all post-stroke upper-limb dysfunction levels.
• Assessment tool selection should be tailored to the individual patient's residual motor function.