Article

OBJECTIVE: To investigate the predictors of minimal clinically important changes
on outcome measures after robot-assisted therapy (RT). DESIGN: Observational
cohort study. SETTING: Outpatient rehabilitation clinics. PARTICIPANTS: A cohort
of outpatients with stroke (N=55). INTERVENTIONS: Patients with stroke received
RT for 90 to 105min/d, 5d/wk, for 4 weeks. MAIN OUTCOME MEASURES: Outcome
measures, including the Fugl-Meyer Assessment (FMA) and Motor Activity Log (MAL),
were measured before and after the intervention. Potential predictors include
age, sex, side of lesion, time since stroke onset, finger extension, Box and
Block Test (BBT) score, and FMA distal score. RESULTS: Statistical analysis
showed that the BBT score (odds ratio[OR]=1.06; P=.04) was a significant
predictor of clinically important changes in the FMA. Being a woman (OR=3.9;
P=.05) and BBT score (OR=1.07; P=.02) were the 2 significant predictors of
clinically significant changes in the MAL amount of use subscale. The BBT score
was the significant predictor of an increased probability of achieving clinically
important changes in the MAL quality of movement subscale (OR=1.07; P=.02). The
R(2) values for the 3 logistic regression models were low (.114-.272).
CONCLUSIONS: The results revealed that patients with stroke who had greater
manual dexterity measured by the BBT appear to have a higher probability of
achieving clinically significant motor and functional outcomes after RT. Further
studies are needed to evaluate other potential predictors to improve the models
and validate the findings.
CI - Copyright (c) 2014 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS