Article

Arm nonuse, defined as the difference between what the individual can
do when constrained to use the paretic arm and what the individual does when
given a free choice to use either arm, has not yet been quantified in individuals
poststroke. OBJECTIVES: (1) To quantify nonuse poststroke and (2) to develop and
test a novel, simple, objective, reliable, and valid instrument, the Bilateral
Arm Reaching Test (BART), to quantify arm use and nonuse poststroke. METHODS:
First, we quantify nonuse with the Quality of Movement (QOM) subscale of the
Actual Amount of Use Test (AAUT) by subtracting the AAUT QOM score in the
spontaneous use condition from the AAUT QOM score in a subsequent constrained use
condition. Second, we quantify arm use and nonuse with BART by comparing reaching
performance to visual targets projected over a 2D horizontal hemi-work space in a
spontaneous-use condition (in which participants are free to use either arm at
each trial) with reaching performance in a constrained-use condition. RESULTS:
All participants (N = 24) with chronic stroke and with mild to moderate
impairment exhibited nonuse with the AAUT QOM. Nonuse with BART had excellent
test-retest reliability and good external validity. CONCLUSIONS: BART is the
first instrument that can be used repeatedly and practically in the clinic to
quantify the effects of neurorehabilitation on arm use and nonuse and in the
laboratory for advancing theoretical knowledge about the recovery of arm use and
the development of nonuse and "learned nonuse" after stroke.

Langue : ANGLAIS