Self-perceived utilization of the paretic arm in chronic stroke requires high upper limb functional ability.
OBJECTIVE
To explore potential predictors of self-reported paretic arm use at baseline and after task-specific training (TST) in survivors of stroke.


METHODS
Data were obtained from a randomized controlled trial of somatosensory stimulation and upper limb TST in chronic stroke.


METHODS
University laboratory.


METHODS
Chronic (≥3mo) survivors of stroke (N=33; mean age, 62y; mean stroke duration, 38mo).


METHODS
Participants received 12 sessions of TST preceded by either active (n=16) or sham (n=17) somatosensory stimulation to all 3 peripheral nerves.


METHODS
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.
Center of Human and Aerospace Physiological Sciences, School of Biomedical Sciences, King's College London, London, UK. Electronic address: melanie.fleming@kcl.ac.uk.
Melanie K
MK
Fleming
Center of Human and Aerospace Physiological Sciences, School of Biomedical Sciences, King's College London, London, UK.
Di J
DJ
Newham
Center of Human and Aerospace Physiological Sciences, School of Biomedical Sciences, King's College London, London, UK; Division of Health and Social Care Research, Department of Physiotherapy, School of Medicine, King's College London, London, UK.
Sarah F
SF
Roberts-Lewis
Division of Health and Social Care Research, Department of Physiotherapy, School of Medicine, King's College London, London, UK.
Isaac O
IO
Sorinola
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001132:Arm / Q000503:physiopathology*; D002908:Chronic Disease; D004599:Electric Stimulation Therapy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010291:Paresis / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D026741:Physical Therapy Modalities; D020127:Recovery of Function / Q000502:physiology*; D012649:Self Concept; D020521:Stroke / Q000150:complications / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D055815:Young Adult
Rehabilitation; Stroke; Upper extremity