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Predictors of Clinically Important Changes in Actual and Perceived Functional Arm Use of the Affected Upper Limb After Rehabilitative Therapy in Chronic Stroke
- Source :
- Archives of physical medicine and rehabilitation. 101(3)
- Publication Year :
- 2019
-
Abstract
- Objective To identify the predictors of minimal clinically important changes in actual and perceived functional arm use of the affected upper limb after rehabilitative therapy. Design Retrospective, observational cohort study. Setting Outpatient rehabilitation settings. Participants A cohort of 94 patients with chronic stroke. Interventions Patients received robot-assisted therapy, mirror therapy, or combined therapy for 4 weeks. Main Outcome Measures The primary outcome measures, assessed pre- and post intervention, included actual functional arm use measured by an accelerometer and perceived functional arm use measured by the Motor Activity Log (MAL). Candidate predictors included age, sex, time after stroke, side of stroke, and scores on the Fugl-Meyer Assessment, Modified Ashworth Scale, Medical Research Council scale, Wolf Motor Function Test, MAL (quality of movement), and Nottingham Extended Activities of Daily Living. Results Being male (odds ratio [OR], 3.17; 95% CI, 1.13-8.87) and having a higher than median Medical Research Council score (OR, 2.68; 95% CI, 1.12-6.41) significantly predicted minimal clinically important changes assessed by an accelerometer. Fugl-Meyer Assessment scores (odds ratio, 1.06; 95% CI, 1.02-1.11) were a significant predictor of achieving clinically important changes in MAL amount of use. Wolf Motor Function Test (quality) scores (OR, 3.05; 95% CI, 1.38-6.77) could predict clinically important improvements in MAL quality of movement. Conclusions Predictors of clinically important changes in the use of the affected upper limb after robot-assisted therapy, mirror therapy, or combined therapy in patients with chronic stroke for 4 weeks differ for actual vs perceived use. Further studies are recommended to validate these findings in a larger sample.
- Subjects :
- Male
030506 rehabilitation
medicine.medical_specialty
Activities of daily living
Modified Ashworth scale
medicine.medical_treatment
Minimal Clinically Important Difference
Physical Therapy, Sports Therapy and Rehabilitation
Upper Extremity
03 medical and health sciences
0302 clinical medicine
Risk Factors
Surveys and Questionnaires
Accelerometry
Activities of Daily Living
Medicine
Humans
Stroke
Retrospective Studies
Rehabilitation
business.industry
Minimal clinically important difference
Stroke Rehabilitation
Odds ratio
Recovery of Function
Middle Aged
medicine.disease
Cohort
Physical therapy
Quality of Life
Female
0305 other medical science
business
030217 neurology & neurosurgery
Cohort study
Subjects
Details
- ISSN :
- 1532821X
- Volume :
- 101
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- Archives of physical medicine and rehabilitation
- Accession number :
- edsair.doi.dedup.....7724787ed2caa6691d4ff62bc5b41310