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Daily Life Upper Limb Activity for Patients with Match and Mismatch between Observed Function and Perceived Activity
Bea Essers1, Marjan Coremans1, Janne Veerbeek2
1Department of Rehabilitation Sciences, KU Leuven, 3001 Leuven, Belgium.
Sensors (Basel, Switzerland)
|September 10, 2021
Summary
Individuals with chronic stroke who perceive low upper limb (UL) activity use their affected UL less daily, even with good observed motor function. This highlights the importance of perceived activity in real-world UL use after stroke.
Area of Science:
- Neurorehabilitation
- Movement Science
- Stroke Recovery
Background:
- Understanding daily upper limb (UL) activity is crucial for improving functional recovery in chronic stroke survivors.
- Observed motor function and perceived activity may not always align, impacting real-world UL engagement.
Purpose of the Study:
- To investigate the relationship between observed UL motor function, perceived UL activity, and actual daily UL activity in chronic stroke.
- To identify discrepancies between perceived and observed UL function and their impact on daily UL use.
Main Methods:
- Sixty chronic stroke patients were assessed for observed UL motor function (Fugl-Meyer Assessment - Upper Extremity [FMA-UE]) and perceived UL activity (Stroke Impact Scale - Hand [SIS-Hand]).
- Daily UL activity was measured over 72 hours using bilateral wrist-worn accelerometers.
- Patients were categorized into 'good match' (good observed function, good perceived activity) and 'mismatch' (good observed function, low perceived activity) groups for comparison.
Main Results:
- The 'mismatch' group showed significantly lower perceived UL activity compared to the 'good match' group (p < 0.001).
- Despite similar observed UL motor function, the affected UL in the 'mismatch' group was less active in daily life (p = 0.013).
- The contribution of the affected UL relative to the unaffected UL (magnitude ratio) was lower in the 'mismatch' group (p = 0.022).
Conclusions:
- Low perceived UL activity in chronic stroke is associated with reduced actual daily use of the affected UL, irrespective of observed motor function.
- Addressing perceived activity limitations may be a key target for interventions aimed at increasing daily UL engagement.
- This study underscores the importance of considering subjective patient experience in conjunction with objective clinical measures for optimizing stroke rehabilitation outcomes.
