Factors related to daily use of the paretic upper limb in patients with chronic hemiparetic stroke–A retrospective cross-sectional study

Abstract

Aims The present study aimed to determine factors associated with the frequency of paralyzed upper extremity (UE) use in chronic stroke patients with severe UE functional deficiency. Methods We retrospectively reviewed the medical records of 138 consecutive patients, and 117 was analyzed (median age, 55 [range, 18–85] years; median stroke duration, 24.5 [range, 7–302] months) with chronic hemiparetic stroke who were admitted to our hospital for intensive upper extremity rehabilitation. The mean Fugl-Meyer Assessment (FMA) UE score was 28.6. All of them are independent in their activity of daily living (ADL) and without remarkable cognitive deficits. Amount-of-use score of Motor Activity Log-14 (MAL-AOU) was applied as the index of daily use of affected UE. The following parameters were examined as the explanatory variables: demographics, proximal and distal sub-scores of FMA UE, Modified Ashworth Scale (MAS), and sensory function scores in the Stroke Impairment Assessment Set (SIAS). Results The median MAL-AOU score was 0.57 [range, 0.28–0.80]. Ordinal regression analysis revealed that FMA proximal, FMA distal, and SIAS sensory function (touch) were associated with AOU score of MAL-14 (Pseudo R-square = 0.460). Conclusion Not only motor but also sensory function, especially tactile sensation, play a crucial role in the daily use of affected UE in chronic stroke patients with severe UE hemiparesis.

Mediating Effect of Upper Limb Use on the Relationship Between Upper Limb Performance and Activities of Daily Living: A Longitudinal Mediation Analysis

“…Herein, ΔAOU and ΔQOM were identified as factors that mediate ΔFMA and ΔFIM (M) after stroke. It has been reported that upper limb usage improves ADL after stroke [ 26 ], and that upper limb function affects the frequency of upper limb use [ 6 ]. Furthermore, the relationship between upper limb function and ADL has been clarified in post-stroke hemiplegia [ 27 ], with Stevenson et al reporting that rehabilitation to increase the frequency of upper limb use improves upper limb function and ADL after stroke [ 28 ].…”

Which sites better represent the sensory function of hands in convalescent stroke patients? A study based on electrophysiological examination

“…The upper limbs and hands play a key role in precise gripping, motor control, and the manipulation of objects ( Tonak et al, 2021 ) and have a significant impact on patients’ activities of daily living ( Tashiro et al, 2021 ). The upper limb and palm of the hand have high sensory thresholds.…”

Facilitation of imitative movement in patients with chronic hemiplegia triggered by illusory ownership

“…Therefore, even in recent stroke rehabilitation, it is important to provide training to increase the frequency of use of paretic limbs. Research examining the factors associated with the frequency of paretic limb use in stroke patients found that both motor and sensory functions determine the contribution of paretic limbs to activities of daily living 18 , 19 . Furthermore, studies have highlighted the important role of paretic arm use in daily life with quantitatively evaluated changes in body ownership associated with decreased sensory and motor functions by measuring body-specific attention, which is defined as the amount of attention directed to the body 20 , 21 .…”