Article

Upper limb disability following stroke may have multiple effects on the
individual. Existing assessment instruments tend to focus on impairment and
function and may miss other changes that are personally important. This study
aimed to identify personally significant impacts of upper limb disability
following stroke. METHODS: Accounts by stroke survivors,
in the form of web-based
diaries (blogs) and stories, were sought using a blog search engine and in
stroke-related web-sites. Thematic analysis using the World Health Organisation's
International Classification of Functioning Disability and Health (ICF) was used
to identify personal impacts of upper limb disability following stroke. RESULTS:
Ninety-nine sources from at least four countries were analysed. Many impacts were
classifiable using the ICF, but a number of additional themes emerged, including
emotional, cognitive and behavioural changes. Blogs and other web-based accounts
were easily accessible and rich sources of data, although using them raised
several methodological issues, including potential sample bias. CONCLUSIONS: A
range of impacts was identified, some of which (such as use of information
technology and alienation from the upper limb) are not addressed in current
assessment instruments. They should be considered in post-stroke assessments.
Blogs may help in the development of more comprehensive assessments. Implications
for Rehabilitation A comprehensive assessment of the upper limb following stroke
should include the impact of upper limb problems on social participation, as well
as associated emotional, cognitive and behavioural changes. Using personalised
assessment instruments alongside standardised measures may help ensure that these
broader domains are considered in discussions between clinicians and patients.
Rehabilitation researchers should investigate whether and how these domains could
be addressed and operationalised in standard upper limb assessment instruments.

Langue : ANGLAIS