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1.
J Youth Adolesc ; 50(3): 437-445, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32892318

RESUMEN

This article discusses three empirical studies of the role of individual agency in educational transitions in the conceptual framework of the motivational theory of lifespan development that integrates life-course sociological and life-span psychological perspectives. The educational systems in the U.K., the US, and Switzerland set up specific opportunities and constraints in their primary to secondary and secondary to tertiary educational tracks. Individual agency plays out in different ways in these country- and transition-specific fields of action and accordingly enables or hinders individual youths' upward mobility. Early transitions into segregated secondary school systems are dominated by the influence of teachers and parents and tend to maintain social inequality. Later transitions into tertiary education are more open to individual agency that can substantially contribute to overcoming social inequalities in college admission. Finally, once enrolled in university, students have comparatively better opportunities to overcome disadvantages of their parents' socio-economic status and educational background.


Asunto(s)
Motivación , Instituciones Académicas , Adolescente , Escolaridad , Humanos , Factores Socioeconómicos , Suiza
2.
Annu Rev Psychol ; 70: 191-217, 2019 01 04.
Artículo en Inglés | MEDLINE | ID: mdl-30110574

RESUMEN

This review addresses conceptual and empirical research about how individual agency and motivation influences development during adulthood and old age. The major life-span approaches to individual agency and developmental regulation are discussed, with a focus on the motivational theory of life-span development. Developmental agency unfolds through action cycles of pursuing long-term goals for optimal development. Individuals differ in their capacity to regulate their goal engagements effectively within the age-graded structure of opportunities and constraints in their life courses. We discuss a set of research examples about specific developmental challenges, such as transition to adulthood, biological aging, illness, and societal transformation, and show how individuals, as agents in their own development, navigate change for better or worse. We conclude with suggestions for future research.


Asunto(s)
Envejecimiento/fisiología , Desarrollo Humano/fisiología , Motivación/fisiología , Autocontrol , Humanos
3.
J Youth Adolesc ; 46(10): 2169-2180, 2017 10.
Artículo en Inglés | MEDLINE | ID: mdl-28689347

RESUMEN

Youth's career attainment is associated with socioeconomic background, but may also be related to their beliefs about causes of success. Relationships between 17-year-olds' socioeconomic status (SES) and causal beliefs about success, and whether these beliefs predict career attainment after completing a vocational or university degree were examined using data from the German Socio-Economic Panel Study (n = 997, 48.5% female). Youth with higher SES parents and those who attended higher levels of high schools were less likely to believe that success in society is due to external causes, but SES was unrelated to the belief that success is due to personal merit or ability. Youth who believe that success is due to external causes attained lower income, occupational prestige, and job autonomy, and slower increases in income over time. There were also significant indirect effects of youth's parents' SES and their own high school levels on career attainment through such external causal beliefs; merit beliefs, by contrast, were largely unrelated to career attainment. These results suggest that beliefs about external causes of success may uniquely contribute to the transmission and maintenance of SES across generations and over time.


Asunto(s)
Conducta del Adolescente/psicología , Aspiraciones Psicológicas , Autoinforme , Percepción Social , Adolescente , Femenino , Humanos , Renta , Masculino , Padres , Autonomía Personal , Autocontrol , Clase Social
4.
Int J Psychol ; 52(1): 40-48, 2017 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-28052330

RESUMEN

The present paper examines university graduates' beliefs about how meritocratic socioeconomic status (SES) attainment in U.S. society is for themselves (merit agency beliefs) and for most other people (merit societal beliefs), and how these distinct beliefs are differentially associated with labour market experiences and achievement-goal attitudes and expectations in the aftermath of the Great Recession. Data from a 10-month longitudinal study of 217 graduates from the 2013 class of a large public U.S. university were analysed using multilevel modelling. The results indicate that most participants optimistically expected to attain upward social mobility. Furthermore, participants' merit agency beliefs were reflective of their labour market prospects and experiences, and calibrated their achievement-goal attitudes and expectations. However, participants' merit societal beliefs were not associated with these labour market experiences and achievement-goal attitudes and expectations. The distinction between merit agency beliefs and merit societal beliefs may be motivationally beneficial by allowing individuals to continue striving toward the uncertain long-term goal pursuit of upward social mobility despite the short-term struggles and setbacks many young adults are likely to experience in the aftermath of the Great Recession.


Asunto(s)
Logro , Aspiraciones Psicológicas , Cultura , Fantasía , Adolescente , Actitud , Femenino , Humanos , Estudios Longitudinales , Masculino , Clase Social , Valores Sociales , Estados Unidos , Universidades , Adulto Joven
5.
J Adolesc ; 53: 95-106, 2016 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-27664569

RESUMEN

Associations between youths' reported relationships with their parents, beliefs about how success is attained, educational aspirations, and university completion were examined. Data come from the German Socioeconomic Panel. At age 17, youth (n = 3284) reported on their relationships with their parents, beliefs about success, and educational aspirations. University completion was assessed up to eight years later. At age 17, perceptions of parental warmth and interest in youths' academics were associated with beliefs that success is due to merit (positively) and that success is due to external factors or dominance over others (negatively). Beliefs that success is due to merit and external factors were associated with educational aspirations positively and negatively respectively. Educational aspirations positively predicted university completion up to eight years later. Relationships with parents had stronger associations with achievement when parents completed a university degree; beliefs about success had stronger associations with aspirations when parents did not.


Asunto(s)
Aspiraciones Psicológicas , Escolaridad , Relaciones Padres-Hijo , Padres , Autoinforme , Estudiantes/psicología , Adolescente , Femenino , Humanos , Masculino , Predominio Social , Factores Socioeconómicos , Encuestas y Cuestionarios , Universidades , Adulto Joven
6.
J Adolesc ; 45: 327-40, 2015 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-26376463

RESUMEN

High school students with high long-term educational expectations attain higher levels of education than those with lower expectations. Less studied is the role of students' short-term college enrollment expectations for the year after high school graduation. The purpose of the current study was to examine the costs and benefits of ambitious short-term expectations and the impact of falling short of these expectations on mental health, motivation, and educational outcomes. Over 1000 youth with expectations to attend college were surveyed during their senior year of high school, one year later, and four years later. Participants who did not achieve their short-term expectations had lower educational attainment four years later but were not less satisfied with their educational progress. The negative consequences of falling short of one's expectations were restricted to individuals with less ambitious short-term expectations. Thus, the benefits of ambitious short-term expectations for youth may outweigh the costs.


Asunto(s)
Aspiraciones Psicológicas , Objetivos , Criterios de Admisión Escolar , Estudiantes/psicología , Universidades , Adolescente , Costos y Análisis de Costo , Femenino , Humanos , Masculino , Motivación , Psicología del Adolescente
7.
Curr Opin Psychol ; 55: 101750, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38039949

RESUMEN

This article addresses the motivational processes that enable older adults to manage health-related threats and to protect their psychological and physical functioning. Based on the Motivational Theory of Life-Span Development (MTD) [1], we describe how an age- and opportunity-adjusted use of control strategies can support the regulation of important developmental goals across the lifespan. In addition, we apply the premises of the MTD to the management of health threats in later adulthood and review the pertinent empirical literature. Finally, we use the Lines-of-Defense model [2] to show how an orchestrated and strategic use of control strategies can help older adults to manage the experience of progressive health declines and remain engaged in the pursuit of important health goals.


Asunto(s)
Conductas Relacionadas con la Salud , Motivación , Anciano , Humanos , Envejecimiento
8.
Gerontology ; 59(5): 438-47, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-23816691

RESUMEN

As older individuals face challenges of progressive disease and increasing disability and approach the end of their lives, their capacity for controlling their environment and own health and functioning declines. The Lines-of-Defense Model is based on the Motivational Theory of Life-Span Development and proposes that individuals can adjust their control striving to the progressive physical decline in distinctly organized cycles of goal engagement and goal disengagement that reflect sequentially organized lines of defense. This organized process allows individuals to hold onto and defend still feasible levels of physical health and functioning in activities of daily living, while adjusting to increasing impairments. As physical constraints become more severe towards the end of life, avoiding psychological suffering becomes the focus of individuals' strivings for control. The Lines-of-Defense Model can also be applied to the inverse process of growth in functioning during recovery and rehabilitation.


Asunto(s)
Envejecimiento/fisiología , Envejecimiento/psicología , Modelos Psicológicos , Actividades Cotidianas/psicología , Adaptación Psicológica , Anciano , Personas con Discapacidad/psicología , Humanos , Motivación , Estrés Psicológico/prevención & control
9.
Aging Ment Health ; 17(3): 375-85, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-23210907

RESUMEN

OBJECTIVE: Drawing from Heckhausen and Schulz's Motivational Theory of Life-span Development, this study examined perceived control as a moderator of the protective relationship between downward social comparison and subjective well-being among older adults. METHODS: Community-dwelling older adults (N = 97, 63% female, ages 79-97) were interviewed in their own homes at three time-points over a nine-year period. Interviews assessed older adults' perceived control over daily tasks, their use of downward social comparison in response to task restriction, and their subjective well-being. RESULTS: Regression analyses yielded a significant interaction between downward social comparison and perceived control for three subjective well-being outcomes: life satisfaction, perceived stress, and depressive symptoms. Follow-up analyses revealed that downward social comparison was associated with greater subjective well-being at low levels of perceived control; but was unrelated to subjective well-being at high levels of perceived control. CONCLUSION: These findings corroborate Heckhausen and Schulz's theorized goal-opportunity congruence premise and have implications for quality-of-life interventions to assist community-dwelling older adults.


Asunto(s)
Actividades Cotidianas/psicología , Estado de Salud , Satisfacción Personal , Calidad de Vida/psicología , Autoimagen , Adaptación Psicológica , Anciano , Anciano de 80 o más Años , Envejecimiento/psicología , Canadá , Femenino , Estudios de Seguimiento , Evaluación Geriátrica , Humanos , Entrevistas como Asunto , Masculino , Percepción , Análisis de Regresión , Apoyo Social
10.
J Youth Adolesc ; 42(9): 1385-98, 2013 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-22956336

RESUMEN

The present study takes a motivational perspective that views youths' educational and career engagement as influential and potentially competing for the same motivational resources in the transition to adulthood. We investigated whether motivational engagement with educational and career goals in the year after high-school graduation was differentially associated with educational, career-related and subjective well-being outcomes 2 and 4 years after school graduation. Our longitudinal study of a multi-ethnic sample of Los Angeles high-school graduates followed participants 2 years (N = 561; 61.5 % female) and 4 years (N = 364; 59.8 % female) after high school graduation. The findings indicate that motivational engagement with educational goals after high school graduation predicted educational attainments and psychological well-being at follow-up 2 and 4 years after graduation, and occupational progress at 4 years after graduation. Work hours assessed shortly after high school graduation were associated with poorer educational outcomes both at 2 and 4 years after high school. Occupational goal engagement was not associated with better outcomes, but predicted less educational attainment 4 years after graduating. Thus, educational goal engagement predicted favorable outcomes, whereas career-related goal engagement for the most part was neutral with some select associations with negative educational outcomes. A strong motivational commitment to educational goals, but not to career goals, is an important component of a successful transition to adulthood.


Asunto(s)
Logro , Desarrollo del Adolescente , Aspiraciones Psicológicas , Selección de Profesión , Objetivos , Salud Mental , Psicología del Adolescente , Adaptación Psicológica , Adolescente , Depresión/etiología , Escolaridad , Empleo , Femenino , Estudios de Seguimiento , Humanos , Entrevistas como Asunto , Estudios Longitudinales , Los Angeles , Masculino , Modelos Psicológicos , Modelos Estadísticos , Satisfacción Personal , Análisis de Regresión , Instituciones Académicas , Adulto Joven
11.
Int J Psychol ; 48(6): 1267-83, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-23173869

RESUMEN

This paper investigates the association between perceptions of broader changes in the social-ecological context and individuals' subjective well-being (SWB). Macro-level societal changes such as globalization or demographic change give rise to new demands for individual functioning at work and/or in the family. Such new demands associated with social change are stressful and likely to be related to lower levels of SWB. Being active agents, individuals attempt to deal with social change and its increasing demands to protect their SWB. The present study investigates which kinds of control strategies are most effective in protecting one's SWB. Specifically, we predicted that control strategies of goal engagement will be most effective under conditions of perceived high control, and control strategies of goal disengagement will be most effective under conditions of perceived low control. In a large sample of 2537 German adults, work- and family-related demands associated with social change were found to be negatively linked to SWB. Moreover and in line with the motivational theory of lifespan development, control strategies of goal engagement and disengagement were beneficial for SWB to the extent that they matched the perceived control of the demands associated with social change.


Asunto(s)
Adaptación Psicológica , Cambio Social , Controles Informales de la Sociedad , Adulto , Femenino , Objetivos , Humanos , Masculino , Percepción , Medio Social , Adulto Joven
12.
Psychol Health ; : 1-17, 2023 May 14.
Artículo en Inglés | MEDLINE | ID: mdl-37183390

RESUMEN

Objective: Patients starting with physical rehabilitation often hold unrealistically high expectations for their recovery. Because of a lower-than-expected rate of recovery, such unrealistic goals have been linked to adverse effects on mental health. Additionally, overtraining due to overly ambitious goals can lead to suboptimal recovery. We investigated the effectiveness of adjusting rehabilitation goals to a more realistic level as a strategy to select appropriate exercise intensity and achieve better recovery outcomes. Design: Patients with arm paralysis from recent stroke were recruited and went through 6-8 weeks of telerehabilitation and in-clinic rehabilitation programme conducted at 11 US sites (N = 124). Main Outcome Measures: Adjustment of recovery goal was assessed in two timepoints during the rehabilitation programme and arm motor function was assessed before and after the clinical trial. Results: Greater use of goal adjustment strategies predicted better recovery of arm motor function, independent from therapy compliance. This pattern was observed only when the choice of exercises is patient-regulated rather than directed by a physical therapist. Conclusion: Benefits from goal adjustment were more pronounced among patients who entered the programme with poorer motor functions, suggesting that goal adjustment is the most beneficial when goals of complete recovery are most unrealistic.

13.
J Gerontol B Psychol Sci Soc Sci ; 77(5): 905-915, 2022 05 05.
Artículo en Inglés | MEDLINE | ID: mdl-34417801

RESUMEN

OBJECTIVES: Life goals are important organizing units for individual agency in development. On a societal level, they align with age-normative developmental tasks; on the individual level, they guide people's attempts at shaping their own development. This study investigates the development of life goals across the adult life span with a focus on differences regarding gender, parental status, education, and region. METHOD: Using longitudinal data from the German Socio-Economic Panel study (N = 52,052, age range: 18-84 years), we estimated the developmental trajectories of importance ratings for 9 life goals across the adult life span using multiple-group latent growth curve modeling. RESULTS: Having a happy relationship or marriage, having children, and being there for others are the life goals rated as most important across almost the entire adult life span. Having a happy relationship or marriage differed strongly by gender. Up to middle adulthood it was more important for women, but more important for men in late adulthood. Parental status amplified gender differences in the work and family domain. Low education was associated with a higher perceived importance of being there for others. The largest regional differences (East vs. West) were found for home ownership. DISCUSSION: Although the importance of some life goal trajectories reflects typical age-grading in developmental tasks, other life goals (e.g., having children) remain important even after goal attainment or after developmental deadlines have passed.


Asunto(s)
Objetivos , Longevidad , Logro , Adulto , Anciano , Anciano de 80 o más Años , Escolaridad , Femenino , Humanos , Masculino , Motivación
14.
Front Psychol ; 13: 902288, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36467136

RESUMEN

This study applied a framework of shared and nonshared agency to investigate how social partners can help and hinder young adults' career development. We also considered the extent to which motivational control could be promoted or burdened when young people seek help and encouragement from others in their careers. Based on the importance of shared agency in life goal pursuit, it was hypothesized that shared agency (i.e., perceived support and collaboration) with mothers, fathers, important adults, and romantic partners would have direct and positive associations with young adults' career satisfaction and exploration and positive indirect associations on career development via motivational control. We further hypothesized that nonshared agency (i.e., directing and uninvolvement) would have direct and negative effects on career satisfaction and exploration and negative indirect effects on career development via motivational strategies. Results indicated that relationships can facilitate career development but differently depending upon relationship type. We found that support and directing from mothers and VIPs had positive associations with outcomes via individual motivational control whereas a total effect of collaboration with fathers and romantic partners were associated with outcomes without an indirect effect via motivational control. These findings are discussed within the context of previous socialization research and theory.

15.
Appl Psychol Health Well Being ; 14(1): 26-43, 2022 02.
Artículo en Inglés | MEDLINE | ID: mdl-34125996

RESUMEN

We investigated motivational regulation involving adjustment of recovery goals in post-stroke rehabilitation via standard in-clinic physiotherapy and in-home telerehabilitation (TR). We used a secondary dataset collected at 11 US sites as part of a clinical trial using video games and game control pads designed to induce certain arm movements required for recovery (n = 124; Mage  = 61.44, SD = 13.30). Participants were randomly assigned to either the TR or in-clinic condition and underwent 36 therapy sessions, reporting on their activity-inherent enjoyment for 6-8 weeks. Compared with the in-clinic patients and TR patients with high game performance, TR patients with lower game performance reported lower activity-inherent enjoyment, which is an important motivational resource for successful recovery. The results suggest that these differences occur because TR patients become discouraged by low game score feedback, which may have signaled a poor prospect for recovery. However, the results also suggest that low game performers who successfully adjusted their recovery goals were resilient to the impact of low game score feedback on their motivational resources and satisfaction with therapy. The findings suggest that goal adjustment may be particularly beneficial when patients are discouraged by feedback indicating suboptimal recovery prospects.


Asunto(s)
Rehabilitación de Accidente Cerebrovascular , Accidente Cerebrovascular , Telerrehabilitación , Objetivos , Humanos , Persona de Mediana Edad , Motivación , Accidente Cerebrovascular/terapia , Rehabilitación de Accidente Cerebrovascular/métodos , Telerrehabilitación/métodos
16.
Psychol Aging ; 36(1): 22-35, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33705183

RESUMEN

Why do people contribute to the well-being of others? What promotes or hinders their contribution? Framed by expectancy-value theory and the motivational theory of life span development, we use data from the Midlife in the United States National longitudinal study (MIDUS I, II, and III) to examine how individuals' perceived contributions to the well-being of others develop across adulthood, in the related but distinct forms of overall prosociality (more other-focused) and generativity (more self-focused). Our findings show that prosociality and generativity display similar, yet distinct trajectories, peaking in midlife a decade apart from each other, when expectancy and value for prosocial behavior are highest. Moreover, expectancy as reflected in perceived control and control strivings, and value as indicated by agreeableness, predict individuals' prosociality and generativity. Trajectories of prosocial contributions further differ according to individual differences in perceived control, control striving, education, income, and number of children, whereas trajectories of generativity only differ across levels of perceived control and income. By applying motivational and life span developmental perspectives, our study offers insight into how prosociality and generativity develop throughout adulthood. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Asunto(s)
Altruismo , Adulto , Envejecimiento , Femenino , Humanos , Estudios Longitudinales , Masculino , Motivación
17.
J Gerontol B Psychol Sci Soc Sci ; 76(Suppl 2): S145-S156, 2021 09 13.
Artículo en Inglés | MEDLINE | ID: mdl-33891014

RESUMEN

The aims of this paper were to review theoretical and empirical research on motivation and healthy aging at work and to outline directions for future research and practical applications in this area. To achieve these goals, we first consider the World Health Organization's (WHO) definition of healthy aging in the context of paid employment and life-span development in the work domain. Second, we describe contemporary theoretical models and cumulative empirical findings on age, motivation, and health and well-being at work, and we critically discuss to what extent they are consistent with the WHO's definition of healthy aging. Finally, we propose several directions for future research in the work context that are aligned with the WHO's definition of healthy aging, and we describe a number of interventions related to the design of work environments and individual strategies to promote the motivation for healthy aging at work.


Asunto(s)
Empleo/psicología , Envejecimiento Saludable , Motivación , Funcionamiento Psicosocial , Sistemas de Apoyo Psicosocial , Trabajo/psicología , Anciano , Investigación Conductal , Envejecimiento Saludable/fisiología , Envejecimiento Saludable/psicología , Humanos , Salud Mental , Rendimiento Físico Funcional , Medio Social , Compromiso Laboral
18.
J Gerontol B Psychol Sci Soc Sci ; 76(Suppl 2): S105-S114, 2021 09 13.
Artículo en Inglés | MEDLINE | ID: mdl-34515773

RESUMEN

This article discusses ways in which aging individuals respond to physical, social, and environmental changes and constraints by modifying their goals. We review aging-related trends, which we derive from several theoretical approaches, including goal systems theory, the motivational theory of life-span development and its action-phase model, and the Selection, Optimization, and Compensation model. These theories explain how biological and social role changes in later adulthood prompt individuals to make changes to the content, orientation, and composition of their goals, including disengaging from and adjusting previously central goals. They also help identify individual differences in the capacity to do so effectively. We review several motivation-related interventions that address the challenges in goal adjustment and call for more research on identifying processes of goal changes conducive to healthy aging, more interventions, and modifications of societal and institutional (e.g., workplace, nursing home) operations that support adaptive goal change in older adults.


Asunto(s)
Adaptación Psicológica , Objetivos , Envejecimiento Saludable , Motivación , Ajuste Social , Anciano , Investigación Conductal/métodos , Envejecimiento Saludable/fisiología , Envejecimiento Saludable/psicología , Humanos , Individualidad , Procesos Mentales , Modelos Psicológicos , Intervención Psicosocial/métodos
19.
Front Neurol ; 12: 603767, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33603709

RESUMEN

Objective: Telerehabilitation (TR) is now, in the context of COVID-19, more clinically relevant than ever as a major source of outpatient care. The social network of a patient is a critical yet understudied factor in the success of TR that may influence both engagement in therapy programs and post-stroke outcomes. We designed a 12-week home-based TR program for stroke patients and evaluated which social factors might be related to motor gains and reduced depressive symptoms. Methods: Stroke patients (n = 13) with arm motor deficits underwent supervised home-based TR for 12 weeks with routine assessments of motor function and mood. At the 6-week midpoint, we mapped each patient's personal social network and evaluated relationships between social network metrics and functional improvements from TR. Finally, we compared social networks of TR patients with a historical cohort of 176 stroke patients who did not receive any TR to identify social network differences. Results: Both network size and network density were related to walk time improvement (p = 0.025; p = 0.003). Social network density was related to arm motor gains (p = 0.003). Social network size was related to reduced depressive symptoms (p = 0.015). TR patient networks were larger (p = 0.012) and less dense (p = 0.046) than historical stroke control networks. Conclusions: Social network structure is positively related to improvement in motor status and mood from TR. TR patients had larger and more open social networks than stroke patients who did not receive TR. Understanding how social networks intersect with TR outcomes is crucial to maximize effects of virtual rehabilitation.

20.
Neurology ; 96(14): e1812-e1822, 2021 04 06.
Artículo en Inglés | MEDLINE | ID: mdl-33589538

RESUMEN

OBJECTIVE: To evaluate the effect of intensive rehabilitation on the modified Rankin Scale (mRS), a measure of activities limitation commonly used in acute stroke studies, and to define the specific changes in body structure/function (motor impairment) most related to mRS gains. METHODS: Patients were enrolled >90 days poststroke. Each was evaluated before and 30 days after a 6-week course of daily rehabilitation targeting the arm. Activity gains, measured using the mRS, were examined and compared to body structure/function gains, measured using the Fugl-Meyer (FM) motor scale. Additional analyses examined whether activity gains were more strongly related to specific body structure/function gains. RESULTS: At baseline (160 ± 48 days poststroke), patients (n = 77) had median mRS score of 3 (interquartile range, 2-3), decreasing to 2 [2-3] 30 days posttherapy (p < 0.0001). Similarly, the proportion of patients with mRS score ≤2 increased from 46.8% at baseline to 66.2% at 30 days posttherapy (p = 0.015). These findings were accounted for by the mRS score decreasing in 24 (31.2%) patients. Patients with a treatment-related mRS score improvement, compared to those without, had similar overall motor gains (change in total FM score, p = 0.63). In exploratory analysis, improvement in several specific motor impairments, such as finger flexion and wrist circumduction, was significantly associated with higher likelihood of mRS decrease. CONCLUSIONS: Intensive arm motor therapy is associated with improved mRS in a substantial fraction (31.2%) of patients. Exploratory analysis suggests specific motor impairments that might underlie this finding and may be optimal targets for rehabilitation therapies that aim to reduce activities limitations. CLINICAL TRIAL: Clinicaltrials.gov identifier: NCT02360488. CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that for patients >90 days poststroke with persistent arm motor deficits, intensive arm motor therapy improved mRS in a substantial fraction (31.2%) of patients.


Asunto(s)
Recuperación de la Función , Rehabilitación de Accidente Cerebrovascular/métodos , Accidente Cerebrovascular , Anciano , Brazo , Femenino , Humanos , Masculino , Persona de Mediana Edad
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