title: Proximal Fugl-Meyer Assessment Scores Predict Clinically Important Upper Limb Improvement After 3 Stroke Rehabilitative Interventions.
abstract: OBJECTIVE
  To identify the baseline motor characteristics of the patients who responded to 3 prominent intervention programs.
  
  
  METHODS
  Observational cohort study.
  
  
  METHODS
  Outpatient rehabilitation clinics.
  
  
  METHODS
  Individuals with chronic stroke (N=174).
  
  
  METHODS
  Participants received 30 hours of constraint-induced movement therapy (CIMT), robot-assisted therapy, or mirror therapy (MT).
  
  
  METHODS
  The primary outcome measure was the change score of the Upper Extremity Fugl-Meyer Assessment (UE-FMA). The potential predicting variables were baseline proximal, distal, and total UE-FMA and Action Research Arm Test scores. We combined polynomial regression analyses and the minimal clinically important difference to stratify the patients as responders and nonresponders for each intervention approach.
  
  
  RESULTS
  Baseline proximal UE-FMA scores significantly predicted clinically important improvement on the primary outcome measure after all 3 interventions. Participants with baseline proximal UE-FMA scores of approximately <30 benefited significantly from CIMT and robot-assisted therapy, whereas participants with scores between 21 and 35 demonstrated significant improvement after MT. Baseline distal and total UE-FMA and Action Research Arm Test scores could also predict upper limb improvement after CIMT and MT, but not after robot-assisted therapy.
  
  
  CONCLUSIONS
  This study could inform clinicians about the selection of suitable rehabilitation approaches to help patients achieve clinically meaningful improvement in upper extremity function.
authors.affiliation: Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Ya-Yun
authors.initials: YY
authors.lastname: Lee
authors.affiliation: Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Yu-Wei
authors.initials: YW
authors.lastname: Hsieh
authors.affiliation: Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Ching-Yi
authors.initials: CY
authors.lastname: Wu
authors.affiliation: School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan. Electronic address: kehchunglin@ntu.edu.tw.
authors.forename: Keh-Chung
authors.initials: KC
authors.lastname: Lin
authors.affiliation: Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Taoyuan, Taoyuan, Taiwan; School of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Chih-Kuang
authors.initials: CK
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D015331:Cohort Studies; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D020127:Recovery of Function; D012047:Rehabilitation Centers; D000071939:Stroke Rehabilitation; D034941:Upper Extremity / Q000503:physiopathology*
keywords: Rehabilitation; Responders; Stroke; Upper extremity