Factors influencing recovery of upper limb motor function during constraint-induced movement therapy for people with stroke.

Objective: The aim of this study is to determine the personal and clinical factors that can predict recovery of motor function in people with stroke. Methods: Characteristics of the study participants such as age, sex, time since stroke and type of stroke, motor function, shoulder pain, amount and quality of use of the affected limb in the real world, wrist and elbow spasticity, handedness, central post-stroke pain and dose of massed practice were recorded. The data obtained were analyzed using descriptive statistics and multiple regression. Results: A total of 144 patients with stroke with mean age, 58.71 ± 19.90 years participated in the study. The result showed that, the whole model significantly explained the total variance by 88.4%, F(14, 144) = 32.870, R 2 = 0. 0.781, p < 0.001. However, in the final model, only four independent variables in the order of degree of predictability, amount of use of the limb in the real world (Beta = 0.455, p = 0.003), intensity of practice during rehabilitation session (Beta = 0.321, p < 0.001), wrist spasticity (Beta = 0.148, p = 0.004) and side affected (Beta = 0.093, p = 0.033) significantly predicted recovery of motor function. Conclusion: Encouraging the use of the limb in the real world may be more important than practice during rehabilitation session in the clinic or in the laboratory.

Predictors of high dose of massed practice following stroke.

Objective: The aim of this study is to determine the factors that affect patients' ability to carry out high dose of massed practice. Methods: Patients with stroke were included in the study if they had no severe impairment in motor and cognitive functions. Dose of massed practice, motor function, perceived amount and quality of use of the arm in the real world, wrist and elbow flexors spasticity, dominant hand stroke, presence of shoulder pain, and central post-stroke pain were assessed on the first day. Dose of massed practice was assessed again on the second day. The data were analyzed using descriptive statistics and linear multiple regression. Results: Only motor function (ß = -0.310, r = 0.787, P < 0.001), perceived amount of use (ß = 0.300, r = 0.823; 95% CI = 0.34-107.224, P = 0.049), severity of shoulder pain (ß = -0.155, r = -0.472, P = 0.019), wrist flexors spasticity (ß = -0.154, r = -0.421, P = 0.002), age (ß = -0.129, r = -0.366, P = 0.018), dominant hand stroke (ß = -0.091, r = -0.075, P = 0.041), and sex (ß = -0.090, r = -0.161, P = 0.036) significantly influenced patients' ability to carry out high dose of massed practice. Conclusion: Many factors affect patients' ability to carry out high dose of massed practice. Understanding these factors can help in designing appropriate rehabilitation.