Symmetrical and bilateral robotic practice, combined with functional task training, can significantly improve motor function, arm activity, and self-perceived bilateral arm ability in patients late after stroke.

Abstract-In this study, we compared the responsiveness and validity of the Box and Block Test (BBT), the Nine-Hole Peg Test (NHPT), and the Action Research Arm Test (ARAT). We randomized 59 patients with stroke into one of three rehabilitation treatments for 3 weeks. We administered six outcome measures (BBT, NHPT, ARAT, Fugl-Meyer Assessment [FMA], Motor Activity Log [MAL], and Stroke Impact Scale [SIS] hand function domain) pretreatment and posttreatment. We used the standardized response mean (SRM) to examine responsiveness and the Spearman rank correlation coefficient (rho) to examine concurrent validity. The BBT, NHPT, and ARAT were moderately responsive to change and not significantly different (SRM = 0.64-0.79). The correlations within the BBT, NHPT, and ARAT were moderate to good at pretreatment (rho = -0.55 to -0.80) and posttreatment (rho = -0.57 to -0.71). The BBT and ARAT showed fair to moderate correlations with the FMA, MAL, and SIS hand function domain at pretreatment and posttreatment (rho = 0.31-0.59), whereas the NHPT demonstrated low to fair correlations with the FMA and MAL (rho = -0.16 to -0.33) and moderate correlations with the SIS hand function domain (rho = -0.58 to -0.66). Our results indicate that the BBT, NHPT, and ARAT are suitable to detect changes over time. While simultaneously considering the responsiveness and validity attributes, the BBT and ARAT can be considered more appropriate for evaluating dexterous function than the NHPT. Further studies with larger samples are needed to validate these findings. Clinical

The assessment of daily living activities could provide information about daily functions and participation restrictions to develop intervention strategies. The purposes of this study were to assess the scores of the Barthel Index (BI) and Lawton Instrumental Activities of Daily Living (IADL) scale in older adults with cognitive impairment and to explore the different effects that levels of cognitive functions have on changes in IADL functions. We recruited 31 participants with dementia, 36 with mild cognitive impairment (MCI), and 35 normal controls (NCs) from the neurology outpatient department of a regional hospital. The results of the demographic and clinical characteristics through the Lawton IADL scale, BI, Quick Mild Cognitive Impairment (Q mci ) screen, Montreal Cognitive Assessment (MoCA), and Mini-Mental State Examination (MMSE), were collected on the same day and compared with the Kruskal–Wallis test, Wilcoxon rank-sum test, Fisher’s exact test, and a multiple linear regression analysis, as appropriate. In the BI, bathing was the most discriminating activity to differentiate patients with MCI and dementia; in the Lawton IADL scale, medication responsibility and shopping were the most discriminating activities to differentiate NCs and patients with MCI, and patients with MCI and dementia, respectively. In addition, the predictors of changes in Lawton IADL scale scores were the problem-solving score of the Clinical Dementia Rating scale, a Q mci score of > 20.4 and an age of ≤ 81.2 years, a MoCA score of < 9.4 and an age of > 81.2 years, and the MMSE score and an age of > 81.2 years. This study adds to the evidence that the description of basic and instrumental daily activities is integrated in older adults with cognitive impairment. Notably, the Q mci is the most significant predictor of changes in IADL function for “young” older adults, as are the MoCA and MMSE for “old” older adults.