OBJECTIVE: To investigate the disuse hypothesis as an explanation for upper limb oedema in patients with stroke. DESIGN: Longitudinal observational study. PATIENTS: Patients with acute hemiparetic stroke were recruited from 2006 to 2009 (n=139). METHODS: Patients wore 2 uni-axial accelerometers, 1 on each wrist, for 2 periods of 48 h with a 1-week interval. Activity performed by the patients with acute stroke was measured by determining total activity, measured as a total sum of raw counts, and calculating the ratio variable. The National Institute of Health Stroke Scale (NIHSS), Fügl-Meyer Assessment and modified Rankin Scale were used. During a 3-month follow-up, patients underwent 3 assessments of upper limb oedema. RESULTS: The incidence of upper limb oedema range for the objective evaluation was 7.7-14.7%, while the incidence for the subjective evaluation ranged from 11.5% to 18.1%. No significant differences were found between patients with and without oedema concerning the activity variables; therefore no prognostic value could be determined. CONCLUSION: No difference in upper limb activity was found between patients with and without oedema after stroke. It is doubtful that loss of activity of the paretic limb is solely responsible for the development of upper limb oedema after stroke.
OBJECTIVE: To investigate the disuse hypothesis as an explanation for upper limb oedema in patients with stroke. DESIGN: Longitudinal observational study. PATIENTS: Patients with acute hemiparetic stroke were recruited from 2006 to 2009 (n=139). METHODS:Patients wore 2 uni-axial accelerometers, 1 on each wrist, for 2 periods of 48 h with a 1-week interval. Activity performed by the patients with acute stroke was measured by determining total activity, measured as a total sum of raw counts, and calculating the ratio variable. The National Institute of Health Stroke Scale (NIHSS), Fügl-Meyer Assessment and modified Rankin Scale were used. During a 3-month follow-up, patients underwent 3 assessments of upper limb oedema. RESULTS: The incidence of upper limb oedema range for the objective evaluation was 7.7-14.7%, while the incidence for the subjective evaluation ranged from 11.5% to 18.1%. No significant differences were found between patients with and without oedema concerning the activity variables; therefore no prognostic value could be determined. CONCLUSION: No difference in upper limb activity was found between patients with and without oedema after stroke. It is doubtful that loss of activity of the paretic limb is solely responsible for the development of upper limb oedema after stroke.
Authors: Henryk F Urbanski; Steven G Kohama; G Alexander West; Christine Glynn; Rebecca L Williams-Karnesky; Eric Earl; Martha N Neuringer; Lauren Renner; Alison Weiss; Mary Stenzel-Poore; Frances Rena Bahjat Journal: Transl Stroke Res Date: 2012-12 Impact factor: 6.829