Article

OBJECTIVE: To explore potential predictors of self-reported paretic arm use at
baseline and after task-specific training (TST) in survivors of stroke. DESIGN:
Data were obtained from a randomized controlled trial of somatosensory
stimulation and upper limb TST in chronic stroke. SETTING: University laboratory.
PARTICIPANTS: Chronic (>/=3mo) survivors of stroke (N=33; mean age, 62y; mean
stroke duration, 38mo). INTERVENTIONS: Participants received 12 sessions of TST
preceded by either active (n=16) or sham (n=17) somatosensory stimulation to all
3 peripheral nerves. MAIN OUTCOME MEASURES: Demographic and clinical
characteristics were entered stepwise into multiple linear regression analyses to
determine the factors that best predict baseline Motor Activity Log (MAL) amount
of use rating and change 3 months after TST. RESULTS: The Action Research Arm
Test (ARAT) score predicted the amount of use at baseline (R(2)=.47, P<.001); in
using this model, an ARAT score of 54 (maximum of 57) is required to score 2.5 on
the MAL (use described as between rarely and sometimes). After TST the change in
the ARAT score predicted the change in the amount of use (R(2)=.31, P=.001). The
predictive power of the model for change at 3 months increased if the Fugl-Meyer
Assessment wrist component score was added (R(2)=.41, P=.001). CONCLUSIONS:
Utilization of the paretic upper limb in activities of daily living requires high
functional ability. The increase in self-reported arm use after TST is dependent
on the change in functional ability. These results provide further guidance for
rehabilitation decisions.
CI - Copyright (c) 2014 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS