Article

A common assumption is that changes in upper limb (UL) capacity, or
what an individual is capable of doing, translates to improved UL performance in
daily life, or what an individual actually does. This assumption should be
explicitly tested for individuals with UL paresis poststroke. OBJECTIVE: To
examine changes in UL performance after an intensive, individualized,
progressive, task-specific UL intervention for individuals at least 6 months
poststroke. METHODS: Secondary analysis on 78 individuals with UL paresis who
participated in a phase II, single-blind, randomized parallel dose-response
trial. Participants were enrolled in a task-specific intervention for 8 weeks.
Participants were randomized into 1 of 4 treatment groups with each group
completing different amounts of UL movement practice. UL performance was assessed
with bilateral, wrist-worn accelerometers once a week for 24 hours throughout the
duration of the study. The 6 accelerometer variables were tested for change and
the influence of potential modifiers using hierarchical linear modeling. RESULTS:
No changes in UL performance were found on any of the 6 accelerometer variables
used to quantify UL performance. Neither changes in UL capacity nor the overall
amount of movement practice influenced changes in UL performance. Stroke
chronicity, baseline UL capacity, concordance, and ADL status significantly
increased the baseline starting points but did not influence the rate of change
(slopes) for participants. CONCLUSIONS: Improved motor capacity resulting from an
intensive outpatient UL intervention does not appear to translate to increased UL
performance outside the clinic.

Langue : ANGLAIS