Predicting shoulder function after constraint-induced movement therapy: a retrospective cohort study

Abstract

Background Several predictors have been associated with upper extremity (UE) recovery after stroke, but characteristics that predict shoulder function after constraint-induced movement therapy (CIMT) have not yet been identified. Objectives To identify predictors associated with satisfactory shoulder function in patients with reduced shoulder function at admission to CIMT. Methods One hundred and seventy five patients were treated using CIMT while in a specialized inpatient hospital. Satisfactory shoulder function was defined according to the functional ability scale of the Wolf Motor Function test. Predictors of satisfactory shoulder function after CIMT were identified using multivariable logistic regression. Results Better distal arm function and good proximal shoulder function on admission to CIMT were strong predictors of satisfactory shoulder function, while age and time of admission to CIMT since stroke were not. Seventeen percent of all CIMT-participants with reduced shoulder function pre-CIMT reached a level of satisfactory shoulder function after CIMT. Discussion A substantial part of patients with reduced shoulder function reached a level of satisfactory shoulder function after CIMT. Intensive CIMT training, comprising tasks that require both distal and proximal UE function, may increase shoulder function in patients with a potential functional reserve.

Three-dimensional kinematics of shoulder function in stroke patients: Inter- and intra-rater reliability

“…Tests began with two static capture periods (standing), followed by measurements during ten repetitions (trials) of two tasks which were ReachLow (WMFT task 5) and ReachHigh (WMFT task 6). These functional tasks were chosen because they did not require grasp and manipulation (Hansen et al, 2018). Each patient was seated on a 45.7 cm high back-less chair facing a 73.5 cm high table.…”

“…We recently used selected tasks from the WMFT to assess shoulder function after constraintinduced movement therapy (CIMT) and found that a substantial part of the patients reached a positive outcome (Hansen et al, 2018). However, it is challenging to use clinical function tests to identify and evaluate specific changes in the process of recovery (Alt Murphy et al, 2015) and in particular to differentiate between compensatory and non-compensatory movements (Levin et al, 2015).…”