Unilateral and bilateral upper extremity weight‐bearing effect on upper extremity impairment and functional performance after brain injury

Abstract

The purpose of the study was to investigate the effect of upper extremity (UE) weight bearing on UE impairment functional performance of persons with acquired brain injury (BI). A quasi-experimental design was used to examine a convenience sample of 99 persons with acquired BI and 22 without BI (WBI) living in a community re-entry centre. A computerized force-sensing array pressure map system was used to determine the UE pressure during unilateral and bilateral conditions. Differences between groups were examined using t-tests. Correlations were computed between UE weight bearing and hand function, and functional performance as measured by the Fugl-Meyer scale and functional independence measure (FIM) scale. The group of people with BI exerted significantly lower UE weight bearing during unilateral conditions as compared with persons WBI [left: t (119) = 2.34, p = 0.021; right: t (119) = 4.79, p = 0.043). UE weight-bearing measures correlated strongly with FIM motor scores with bilateral UE conditions yielded the highest significant correlation (bilateral left r = 0.487, p < 0.001; bilateral right r = 0.469, p < 0.01). The results indicated that UE weight-bearing pressure differs in unilateral and bilateral conditions, between persons with and WBI and between persons with stroke and traumatic brain injury. These findings may have implications for occupational therapists that use unilateral versus bilateral motor training for rehabilitation. There is a need to replicate the study design with a randomized and stratified sample of persons with BI.

Accentuate the Positive: Reflections on Empathic Interpersonal Interactions

“…I gave great attention to the person's eyes, which I feel act as the hands of the face in grasping details in the environment and in helping us express emotions. I found that some motor impairment, including asymmetrical weight bearing, limited trunk movements, and impaired kinematics, could cloud communication (Abreu, 1995;Abreu, Reistetter, Bear-Lehman, & Ottenbacher, 2009;Nakamura, Abreu, Patterson, Buford, & Ottenbacher, 2008). For example, some clients were erroneously described as passive or detached when they were unable to use their extremity movements to express emotion and enhance communication.…”

Occupational therapy and neuromotor interventions

“…The effect of triweekly intervention for improved grasp function in chronic hemiplegia is examined by Conti and Schepens (2009) in Changes in hemiplegic grasp following distributed repetitive intervention: a case series. Reistetter et al (2009), in Unilateral and bilateral upper extremity weightbearing effect on upper extremity impairment and functional performance after brain injury, provide insight into differences between stroke and traumatic brain injury response to weight-bearing. Finally, the effect of a robotic-assisted intervention is described by Flinn et al (2009) in Effects of robotic aided rehabilitation on recovery of upper extremity function in chronic stroke: a single case study.…”

The Effects of Weight-Bearing Exercise on Upper Extremity Activities Performance in the Female Stroke Patients

“…Nawoczenski et al [17] analyzed the kinetics of the scapulae of patients with spinal cord injuries during weight-bearing motions and reported that these motions were effective in relieving shoulder pain. Reistetter et al [18] reported that bilateral weight-bearing conditions and patients' independent functions were significantly correlated. Therefore, it can be stated that upper extremity weight-bearing also affects patients' pain and functional activities.…”