The Test-Retest Reliability and Minimal Detectable Change of the Fugl-Meyer Assessment of the Upper Extremity and 9-Hole Pegboard Test in Individuals With Subacute Stroke

Achacheluee, Sahar Toluee; Rahnama, Leila; Karimi, Nouredin; Abdollahi, Iraj; Jaberzadeh, Shapour; Arslan, Syed Asadullah

doi:10.15412/j.ptj.07050406

Cited by 6 publications

(5 citation statements)

References 33 publications

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“…The UE-FM is a valid and reliable assessment of performance-based impairment after stroke, measured on 0–3 ordinal scale (0 = cannot perform; 3 = performs faultlessly) with a maximum possible score of 66 points ( Gladstone et al, 2002 ; Hsieh et al, 2009 ; Kim et al, 2012 ). The MDC (Minimum Detectable Change) is 1.56 points and the MCID (Minimal Clinically Important Difference) is 4.25 points ( Page et al, 2012 ; Toluee Achacheluee et al, 2016 ).…”

Section: Methodsmentioning

confidence: 99%

Transcutaneous Auricular Vagus Nerve Stimulation (tAVNS) Delivered During Upper Limb Interactive Robotic Training Demonstrates Novel Antagonist Control for Reaching Movements Following Stroke

et al. 2021

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Implanted vagus nerve stimulation (VNS) delivered concurrently with upper limb rehabilitation has been shown to improve arm function after stroke. Transcutaneous auricular VNS (taVNS) offers a non-invasive alternative to implanted VNS and may provide similar therapeutic benefit. There is much discussion about the optimal approach for combining VNS and physical therapy, as such we sought to determine whether taVNS administered during robotic training, specifically delivered during the premotor planning stage for arm extension movements, would confer additional motor improvement in patients with chronic stroke. Thirty-six patients with chronic, moderate-severe upper limb hemiparesis (>6 months; mean Upper Extremity Fugl-Meyer score = 25 ± 2, range 13–48), were randomized to receive 9 sessions (1 h in length, 3x/week for 3 weeks) of active (N = 18) or sham (N = 18) taVNS (500 ms bursts, frequency 30 Hz, pulse width 0.3 ms, max intensity 5 mA, ∼250 stimulated movements per session) delivered during robotic training. taVNS was triggered by the onset of a visual cue prior to center-out arm extension movements. Clinical assessments and surface electromyography (sEMG) measures of the biceps and triceps brachii were collected during separate test sessions. Significant motor improvements were measured for both the active and sham taVNS groups, and these improvements were robust at 3 month follow-up. Compared to the sham group, the active taVNS group showed a significant reduction in spasticity of the wrist and hand at discharge (Modified Tardieu Scale; taVNS = –8.94% vs. sham = + 2.97%, p < 0.05). The EMG results also demonstrated significantly increased variance for the bicep peak sEMG amplitude during extension for the active taVNS group compared to the sham group at discharge (active = 26.29% MVC ± 3.89, sham = 10.63% MVC ± 3.10, mean absolute change admission to discharge, p < 0.01), and at 3-month follow-up, the bicep peak sEMG amplitude was significantly reduced in the active taVNS group (P < 0.05). Thus, robot training improved the motor capacity of both groups, and taVNS, decreased spasticity. taVNS administered during premotor planning of movement may play a role in improving coordinated activation of the agonist-antagonist upper arm muscle groups by mitigating spasticity and increasing motor control following stroke.Clinical Trial Registration:www.ClinicalTrials.gov, identifier (NCT03592745).

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Section: Methodsmentioning

confidence: 99%

Transcutaneous Auricular Vagus Nerve Stimulation (tAVNS) Delivered During Upper Limb Interactive Robotic Training Demonstrates Novel Antagonist Control for Reaching Movements Following Stroke

et al. 2021

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“…The patient should use problem-solving skills and self-monitoring to transfer the interventions to daily living activities, but these patients refuse to use the affected hand due to motor and functional limitations; hence, in the long term, they will not get acceptable outcome from this intervention [29]. However, studies using transcranial magnetic stimulation have shown an increase in short-term [32] and long-term [33] activity of cerebral cortex after modified CIMT. Therefore, the long-term outcome of modified CIMT is not clear yet.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Modified Constraint-Induced Movement Therapy on Upper Extremity Function of a Patient With Severe Acquired Brain Injury

Abedi

Akbarfahimi

2020

J. Rehabil.

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Objective This study aimed to investigate the effect of modified Constraint-Induced Movement Therapy (CIMT) on upper extremity function of a patient with severe Acquired Brain Injury (ABI). Materials & Methods This study was conducted in 2017. The patient was a 33-year-old right-handed woman with a severe ABI admitted to Rofeideh Rehabilitation Center suffering from severe hypoxia due to suicide by hanging. She had no motion limitation, no history of dislocation or fracture, and no complaints of pain in the upper extremity, at the more involved side (left). The informed consent letter was obtained from the participant. The inclusion criteria for the subject were: active wrist extension of at least 20 degrees, maintaining balance for two minutes, Ashworth scale score <3, and mini-mental state examination score >24. The intervention was performed for two weeks, five days a week, three hours a day at Rofeideh Center. For the less affected upper limb, sling and mitt were used as constraints for at least six hours a day. We first used traditional techniques to reduce muscle tone (weight-bearing through upper extremity, trunk rotation, scapular protrusion, and reflex-inhibition pattern). Then, some selected motor tasks with shaping techniques were used. These tasks included cleaning the table with a towel, flipping the pages of a book, picking up the glass and carrying it to the mouth, picking up and moving a bottle, practicing to pick up and drop different objects, reaching arm forward to move objects from one place to another, counting with fingers, picking up and rotating a card, and doing fine exercises and fine motor and in-hand manipulation tasks by using coins and cereals. Assessments were performed at 4 stages of before, and then 2, 4, and 6 weeks after the intervention using Fugl-Meyer Assessment (FMA), Functional Independence Measure (FIM), Motor Activity Log (MAL), and Box and Block Test (BBT). Results Improvement in the upper extremity function of a patient with chronic and severe ABI can be achieved by using the modified CIMT. According to FMA scores, an improvement was observed in four areas of motor function, balance, sensation, and range of motion. Its score increased from 24 at baseline to 56, two weeks after the intervention, and remained constant up to six weeks later. Also, manual dexterity under BBT was improved. Its score reached from 5 to 7, two weeks after, and 12, six weeks after the intervention. Moreover, the patient's FIM score improved from 19 to 36, two weeks after, and 38, six weeks after the intervention. Furthermore, regarding MAL results, the amount of movement score increased from 0 to 1.70, and the quality of movement score increased from 0 to 1.66, six weeks after the intervention. Conclusion Modified CIMT can be an effective method for improving the upper extremity function of patients with chronic and severe ABI in a short period.

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“…For this purpose, we will utilize the wrist position sense test (24)and hand active sensation test (25) to assess sensory function. Additionally, we will employ the box & block test (26), grip dynamometer test (27,28), Purdue Pegboard test (29), Nine-Hole Peg test (30,31), and coin rotation test (32,33) to evaluate fine and gross motor function.…”

Section: Sensory-motor Skills Of Upper Extremitymentioning

confidence: 99%

Evaluating the Effects of Bimanual Activities with and Without Motivational Strategies on Participation and Upper Extremity Function in Subjects with Parkinson's Disease: Study Protocol for a Randomized Controlled Trial

Azad,

Taghizadeh,

Akbarfahimi

et al. 2024

Middle East J Rehabil Health Stud

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Background: Parkinson's disease (PD) is a neurodegenerative disorder characterized by motor and non-motor symptoms that can impact daily activities. Objectives: Activity-based interventions, particularly when combined with motivational strategies, may enhance upper extremity function and participation in people with PD. Methods: This study will include forty-five patients with PD aged 35 to 85 years, categorized as stages I to III according to the Hoehn and Yahr Scale. Patients will be recruited from neurological and rehabilitation centers and randomly assigned to one of three intervention groups: Activity-based interventions with motivational strategy, activity-based interventions without motivational strategy, and conventional interventions. All participants will undergo a 24-session intervention, three times a week. The study will assess various outcomes at multiple time points, including baseline, session 10, session 18, post-intervention (week 9), and follow-up (week 17). Primary outcome measures will focus on motor control of the upper extremity and participation, while secondary outcome measures will include cognitive function and quality of life. Results: This proposed randomized controlled trial (RCT) aims to investigate the potential beneficial effects of activity-based interventions, combined with motivational strategies, on upper extremity function and participation in activities of daily living (ADLs) for individuals with PD. Conclusions: The expected outcome of this study is to provide valuable insights that can assist occupational therapists in making informed decisions regarding intervention plans for people with PD.

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The Test-Retest Reliability and Minimal Detectable Change of the Fugl-Meyer Assessment of the Upper Extremity and 9-Hole Pegboard Test in Individuals With Subacute Stroke

Cited by 6 publications

References 33 publications

Transcutaneous Auricular Vagus Nerve Stimulation (tAVNS) Delivered During Upper Limb Interactive Robotic Training Demonstrates Novel Antagonist Control for Reaching Movements Following Stroke

Transcutaneous Auricular Vagus Nerve Stimulation (tAVNS) Delivered During Upper Limb Interactive Robotic Training Demonstrates Novel Antagonist Control for Reaching Movements Following Stroke

The Effect of Modified Constraint-Induced Movement Therapy on Upper Extremity Function of a Patient With Severe Acquired Brain Injury

Evaluating the Effects of Bimanual Activities with and Without Motivational Strategies on Participation and Upper Extremity Function in Subjects with Parkinson's Disease: Study Protocol for a Randomized Controlled Trial

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