Factors Explaining Limited Daily Hand-use in Individuals with Fair-Good Motor Ability Post-Stroke

Area of Science:

• Neurorehabilitation
• Stroke Recovery
• Upper Extremity Function

Background:

• Individuals post-stroke often have limited daily hand-use despite adequate motor ability.
• Factors beyond motor impairment may influence functional hand use after stroke.

Purpose of the Study:

• To identify factors explaining daily hand-use variance beyond motor impairment in stroke survivors.
• To investigate the role of proprioception, executive functions, self-efficacy, and depressive symptoms.

Main Methods:

• Cross-sectional study of stroke survivors with fair-to-good upper extremity motor ability (Fugl-Meyer Assessment > 30/66).
• Assessed daily hand-use via the Rating of Everyday Arm-Use in the Community and Home (REACH) questionnaire.
• Evaluated proprioception, executive functions (dual-task capacity), self-efficacy, and depressive symptoms.

Main Results:

• Despite high motor ability, daily hand-use was limited (REACH levels 2-3/5).
• Dual-task capacity and self-efficacy significantly predicted hand-use, explaining 45.9% of variance.
• Increased dual-task capacity (5.8%) and self-efficacy (4.2%) correlated with higher REACH levels.

Conclusions:

• Reduced dual-task capacity and self-efficacy are key factors limiting hand-use in stroke survivors with good motor ability.
• These factors present potential targets for rehabilitation interventions.
• Clinical assessments should consider cognitive and psychological factors impacting hand function.