Article

OBJECTIVE: To test the feasibility of the Fugl-Meyer Assessment of the Upper
Extremity "keyform," derived from Rasch analysis, as a method for systematically
planning and progressing rehabilitation. DESIGN:
Feasibility study, single group
design. SETTING: University rehabilitation research laboratory. PARTICIPANTS:
Participants (N=10; mean age, 59.70+/-9.96y; 24.1+/-30.54mo poststroke) with
ischemic or hemorrhagic stroke >3 months prior, voluntarily shoulder flexion
>/=30 degrees , and simultaneous elbow extension >/=20 degrees . INTERVENTIONS:
The keyform method defined initial rehabilitation targets (goals) and progressed
the rehabilitation program after every third session. Targets were repetitively
practiced within the context of client-selected functional tasks not in
isolation. MAIN OUTCOME MEASURES: Feasibility was defined by subject's pain or
fatigue, upper extremity motor function (Wolf Motor Function Test), and movement
patterns (kinematics). Assessments were administered pre- and posttreatment and
compared using paired t tests. Task-difficulty and patient-ability measures were
calculated using Rasch analysis and compared using paired t tests (P<.05).
RESULTS: Ten participants completed 9 sessions, 200 movement repetitions per
session in <2 hours without pain or fatigue. Participants gained upper extremity
motor function (Wolf Motor Function Test: pretreatment, 22.23+/-24.26s;
posttreatment, 15.46+/-22.12s; P=.01), improved shoulder-elbow coordination
(index of curvature: pretreatment, 1.30+/-0.15; posttreatment, 1.21+/-0.11;
P=.01), and exhibited reduced trunk compensatory movement (trunk displacement:
pretreatment, 133.97+/-74.15mm; posttreatment, 108.08+/-64.73mm; P=.02).
Task-difficulty and patient-ability measures were not statistically different
throughout the program (person-ability measures of 1.01+/-0.05, 1.64+/-0.45, and
2.22+/-0.65 logits and item-difficulty measures of 0.93+/-0.37, 1.70+/-0.20, and
2.06+/-0.24 logits at the 3 testing time points, respectively; P>.05).
CONCLUSIONS: The Fugl-Meyer Assessment of the Upper Extremity keyform is a
feasible method to ensure that the difficulty of tasks practiced were well
matched to initial and evolving levels of upper extremity motor ability.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS