title: Does Task-Specific Training Improve Upper Limb Performance in Daily Life Poststroke?
abstract: A common assumption is that changes in upper limb (UL) capacity, or what an individual is capable of doing, translates to improved UL performance in daily life, or what an individual actually does. This assumption should be explicitly tested for individuals with UL paresis poststroke.
  
  
  
  To examine changes in UL performance after an intensive, individualized, progressive, task-specific UL intervention for individuals at least 6 months poststroke.
  
  
  
  Secondary analysis on 78 individuals with UL paresis who participated in a phase II, single-blind, randomized parallel dose-response trial. Participants were enrolled in a task-specific intervention for 8 weeks. Participants were randomized into 1 of 4 treatment groups with each group completing different amounts of UL movement practice. UL performance was assessed with bilateral, wrist-worn accelerometers once a week for 24 hours throughout the duration of the study. The 6 accelerometer variables were tested for change and the influence of potential modifiers using hierarchical linear modeling.
  
  
  
  No changes in UL performance were found on any of the 6 accelerometer variables used to quantify UL performance. Neither changes in UL capacity nor the overall amount of movement practice influenced changes in UL performance. Stroke chronicity, baseline UL capacity, concordance, and ADL status significantly increased the baseline starting points but did not influence the rate of change (slopes) for participants.
  
  
  
  Improved motor capacity resulting from an intensive outpatient UL intervention does not appear to translate to increased UL performance outside the clinic.
authors.affiliation: 1 Washington University, St Louis, MO, USA.
authors.forename: Kimberly J
authors.initials: KJ
authors.lastname: Waddell
authors.affiliation: 1 Washington University, St Louis, MO, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Strube
authors.affiliation: 1 Washington University, St Louis, MO, USA.
authors.forename: Ryan R
authors.initials: RR
authors.lastname: Bailey
authors.affiliation: 1 Washington University, St Louis, MO, USA.
authors.forename: Joseph W
authors.initials: JW
authors.lastname: Klaesner
authors.affiliation: 1 Washington University, St Louis, MO, USA.
authors.forename: Rebecca L
authors.initials: RL
authors.lastname: Birkenmeier
authors.affiliation: 2 Georgetown University, Washington, DC, USA.|3 MedStar National Rehabilitation Hospital, Washington DC, USA.
authors.forename: Alexander W
authors.initials: AW
authors.lastname: Dromerick
authors.affiliation: 1 Washington University, St Louis, MO, USA.
authors.forename: Catherine E
authors.initials: CE
authors.lastname: Lang
mesh_terms: D061725:Accelerometry; D000203:Activities of Daily Living; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010291:Paresis / Q000503:physiopathology / Q000534:rehabilitation; D016037:Single-Blind Method; D020521:Stroke / Q000503:physiopathology*; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D034941:Upper Extremity / Q000503:physiopathology*
keywords: accelerometry; stroke; task-specific training; upper limb