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Does Task-Specific Training Improve Upper Limb Performance in Daily Life Poststroke?

Kimberly J Waddell1, Michael J Strube1, Ryan R Bailey1

  • 11 Washington University, St Louis, MO, USA.

Neurorehabilitation and Neural Repair
|December 3, 2016
PubMed
Summary
This summary is machine-generated.

Intensive upper limb (UL) training after stroke improved capacity but not actual UL performance in daily activities. This suggests capacity gains do not automatically translate to real-world functional improvements for stroke survivors.

Keywords:
accelerometrystroketask-specific trainingupper limb

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Area of Science:

  • Neurorehabilitation
  • Motor Recovery
  • Stroke Research

Background:

  • A common assumption is that improved upper limb (UL) capacity post-stroke leads to better UL performance in daily life.
  • This assumption requires explicit testing in individuals with UL paresis.

Purpose of the Study:

  • To investigate changes in UL performance after an intensive, individualized, task-specific UL intervention for individuals with chronic stroke (≥6 months post-stroke).

Main Methods:

  • Secondary analysis of 78 participants in a randomized dose-response trial.
  • Participants received an 8-week task-specific UL intervention with varying movement practice.
  • UL performance was objectively measured weekly using bilateral wrist-worn accelerometers over 24-hour periods.

Main Results:

  • No significant changes in UL performance were observed across the 6 accelerometer variables.
  • Neither improvements in UL capacity nor the total amount of movement practice correlated with changes in UL performance.
  • Factors like stroke chronicity and baseline capacity influenced initial performance but not the rate of change.

Conclusions:

  • Intensive outpatient UL interventions may enhance motor capacity but do not consistently translate to increased real-world UL performance in individuals post-stroke.
  • The assumption that capacity gains directly improve daily UL performance warrants re-evaluation.