Lay Fong Chin1, Kathryn Hayward, Sandra G Brauer. 1. Rehabilitation Centre, Tan Tock Seng Hospital, Singapore 569 766 Physiotherapy, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane Australia 4072 Physiotherapy, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane Australia 4072 Stroke Theme, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne VIC Australia 3084 NHMRC Centre of Research Excellence in Stroke Rehabilitation and Brain Recovery, Australia Physiotherapy, Melbourne School of Health Sciences, University of Melbourne, Parkville Australia 3052 Physiotherapy, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane Australia 4072.
Abstract
OBJECTIVE: This study aims to investigate factors related to paretic upper limb use within first 4-weeks post-stroke. DESIGN: Sixty inpatients within 4-weeks of first-time stroke were stratified by severity defined by Fugl Meyer upper limb score: severe=0-22, moderate=23-50, mild=51-66. All wore a wrist accelerometer on the paretic upper limb (24hours). Factors investigated were measures of: upper limb motor impairment; mobility; balance; functional independence; sensory impairment; cognitive function; social factors; environmental restriction and knowledge. Individual and multivariate quantile regression analysis were performed. RESULTS: Upper limb motor impairment, mobility, balance, functional independence, self-efficacy and knowing how to use the paretic upper limb were significantly related to upper limb use across three impairment groups (pseudo R2= 0.079-0.492, p<0.02). Multivariate regression showed the only significant factor in moderate and mild group was Fugl Meyer Upper Limb score (moderate pseudo R2= 0.55; mild pseudo R2=0.54; p<0.001). For severe group, Fugl Meyer upper limb score and step count were significant (severe pseudo R2=0.47; p≤0.030). CONCLUSIONS: Upper limb motor impairment is significantly associated with paretic upper limb use across three impairment groups, and step count with severe group. Strategies to improve upper limb motor impairment and increase mobility may be required to increase upper limb use.
OBJECTIVE: This study aims to investigate factors related to paretic upper limb use within first 4-weeks post-stroke. DESIGN: Sixty inpatients within 4-weeks of first-time stroke were stratified by severity defined by Fugl Meyer upper limb score: severe=0-22, moderate=23-50, mild=51-66. All wore a wrist accelerometer on the paretic upper limb (24hours). Factors investigated were measures of: upper limb motor impairment; mobility; balance; functional independence; sensory impairment; cognitive function; social factors; environmental restriction and knowledge. Individual and multivariate quantile regression analysis were performed. RESULTS:Upper limb motor impairment, mobility, balance, functional independence, self-efficacy and knowing how to use the paretic upper limb were significantly related to upper limb use across three impairment groups (pseudo R2= 0.079-0.492, p<0.02). Multivariate regression showed the only significant factor in moderate and mild group was Fugl Meyer Upper Limb score (moderate pseudo R2= 0.55; mild pseudo R2=0.54; p<0.001). For severe group, Fugl Meyer upper limb score and step count were significant (severe pseudo R2=0.47; p≤0.030). CONCLUSIONS:Upper limb motor impairment is significantly associated with paretic upper limb use across three impairment groups, and step count with severe group. Strategies to improve upper limb motor impairment and increase mobility may be required to increase upper limb use.