Upper Limb Performance in Daily Life Improves Over the First 12 Weeks Poststroke.

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Biomedical Engineering

Background:

• Upper limb (UL) use in daily life is complex post-stroke.
• UL impairment recovery is documented, but daily UL performance trajectories and psychosocial moderators are less understood.
• Early post-stroke UL sensor-measured performance and its influencing factors require further investigation.

Purpose of the Study:

• To examine the recovery trajectory of sensor-measured UL performance within 12 weeks post-stroke.
• To characterize the moderating role of belief, confidence, and motivation on UL performance.
• To investigate the relationship between self-perceived barriers and UL performance.

Main Methods:

• Longitudinal, prospective cohort study design.
• Bilateral, wrist-worn accelerometers quantified UL performance over 5 sessions (24-hour periods).
• Surveys assessed belief, confidence, motivation, and self-perceived barriers; hierarchical linear modeling and correlation analyses were used.

Main Results:

• UL performance significantly improved over the first 12 weeks post-stroke.
• Belief, confidence, and motivation did not moderate UL performance recovery over time.
• A negative relationship between UL performance and self-perceived barriers was observed early post-stroke, diminishing over time.

Conclusions:

• Sensor-measured UL performance demonstrates improvement in the early stages following stroke.
• Rehabilitation interventions may benefit from focusing on reducing self-perceived barriers to UL recovery.
• Directly targeting belief, confidence, and motivation may not be essential for early UL performance enhancement post-stroke.