Effect of Perceptive Exploration Activity on Spoon Manipulation by Paralyzed Upper Extremity with Sensory Disturbance in a Patient with Stroke Hemiparesis: A Single-Subject Research Design

Abstract

Introduction: Functional use of a paralyzed upper extremity in patients with hemiparesis after stroke depends on the specificity of the task. Further, task specificity-dependent upper extremity use is an important factor in the recovery of upper extremity function. The purpose of this study was to investigate the usefulness of a perceptive exploration activity in consideration of the specificity of the task for Japanese male patient in his 70s and monitor its effect on spoon manipulation using the affected arm. Methods: A single-subject research design was implemented in the ABAB trial. The facilitation of selective movement of the paralyzed upper extremity and self-care skill training were provided during baseline A and A' as occupational therapy (OT). In addition to the OT, 10 minutes of perceptive exploration activity was added during the interventions B and B'. The required time (RT) and number of errors (NOE) in task performance were monitored as the outcome of the therapeutic effect. Goal Attainment Scaling (GAS) and Fugl-Meyer Assessment (FMA) were also adopted to evaluate individual goals and changes in upper extremity function. Results: RT and NOE in task performance were decreased with interventions B and B' compared to baselines A and A'. GAS score improved in interventions B and B', and FMA showed a gradual improvement within each phase. Conclusion: Spoon manipulation using the paralyzed upper extremity with sensory disturbance was improved by perceptive exploration activity. Current therapy suggests that perceptive exploration activity may be effective in improving movement skills in the manipulation of tools.