U-Rate-UE; Measuring Perceived Recovery of the Affected Upper Extremity in Adults Post-stroke.

OBJECTIVE: To establish initial validity of "U-Rate-UE", a single-question scale regarding perceived recovery of the stroke affected upper extremity (UE). DESIGN: A retrospective longitudinal study of data collected at rehabilitation admission, 6 weeks, and 6 months since stroke. SETTING: Stroke rehabilitation and community-based. PARTICIPANTS: A convenience sample of 87 individuals, median (interquartile range) age 71.5 (65-80) years, 15.0 (12-20) days post-stroke. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The affected UE was assessed using the Fugl-Meyer Motor Assessment, grip strength, Action Research Arm Test, the Box and Block Test (BBT), and The Rating of Everyday Arm-Use in the Community and Home. Participants also rated how much they perceive that their affected UE recovered from the stroke using U-Rate-UE; 0-100 (no to full recovery). Longitudinal changes in U-Rate-UE ratings were assessed. In addition, at 6 weeks and 6 months post-stroke, the change in BBT was calculated and participants were grouped into achieved/did not achieve the minimal detectable change (MDC). Correlations between U-Rate-UE to the other UE assessments were assessed at all 3 timepoints. RESULTS: Significant changes in U-Rate-UE were seen over time (P<.05). At 6 weeks and 6 months, participants who achieved BBT-MDC rated their recovery significantly higher than participants who did not. U-Rate-UE was moderately-strongly significantly correlated to UE assessments (rho=.61-.85, P<.001). CONCLUSIONS: The U-Rate-UE is supported for use with UE assessments contributing to comprehensive clinical understanding of the recovery of the affected UE in adults post-stroke.

Wrist Plane of Motion and Range During Daily Activities.

OBJECTIVE: The dart-throwing motion (DTM) is a multiplane wrist motion that is needed for many daily occupations. Mobilization along the DTM plane may be essential for rehabilitation after wrist injury, but DTM angles are reported for the dominant hand alone, so their relevance to injury in the nondominant hand cannot be surmised. The aim of this study was to quantify the DTM plane angles for both hands during different activities of daily living (ADLs). METHOD: Forty-three healthy participants wore a twin-axis electrogoniometer during ADLs. RESULTS: No significant differences were found between the DTM plane angles of the dominant (20°-45°) and nondominant (15°-40°) hands. These angles varied by task and across participants. CONCLUSION: The DTM plane is a functional motion used by both hands during ADLs. Because the DTM plane angle differs among hands, tasks, and individual clients, wrist rehabilitation involving the DTM plane should not be limited to a singular DTM plane angle.

Is Unilateral Spatial Neglect Associated With Motor Recovery of the Affected Upper Extremity Poststroke? A Systematic Review.

BACKGROUND AND PURPOSE: Individuals with stroke often present symptoms of multiple domains, such as weakness of the affected upper extremity (UE) and unilateral spatial neglect (USN), which are both associated with poor functional outcome. The aims of this systematic review were to search and review studies that investigated (1) the relationship between USN and affected UE sensorimotor recovery poststroke and (2) the effectiveness of sensorimotor interventions to improve the affected UE in patients with USN. METHODS: An electronic search of databases (MEDLINE, EMBASE, CINAHL and Cochrane CENTRAL) was conducted using a combination of the following terms: stroke, USN, and affected UE. Studies meeting the inclusion criteria were rated using a modified version of the Quality Index, and relevant data were extracted. RESULTS: A total of 850 studies were identified, and 14 were included; 13 studies assessed correlations between USN and the affected UE capacity/recovery, and 1 study assessed an intervention to improve the UE of individuals with USN. An association between presence of USN and UE capacity/recovery was found in most studies and USN did not interfere with recovery of the affected UE in the single experimental study. CONCLUSIONS: USN is associated with poor UE motor capacity and less UE recovery poststroke. Therefore, these impairments should be considered when planning rehabilitation and discharge. Because USN is a well-researched phenomenon, the lack of studies and insufficient evidence related to UE interventions in individuals with USN was unexpected. These interventions should be developed and researched to improve UE and overall functional outcome poststroke.