Posts Tagged Arm use
[ARTICLE] Recovery of upper limb function is greatest early after stroke but does continue to improve during the chronic phase: a two-year, observational study – Full Text
Up to 70% of individuals experience difficulties using their upper limb (UL, arm and hand) to perform meaningful activities after stroke . There is an assumption that when a stroke survivor demonstrates a change in activity, it is underpinned by an improvement in their capacity (i.e., what a person can do in the clinical environment) and performance (i.e., does a person actually use their UL in real world environments outside of the clinic) . However, UL recovery post-stroke is unlikely to be this simplistic . Understanding how capacity and performance change over years post-stroke might help to identify which patients to target and when during their recovery.
Previous research has noted distinct recovery profiles during inpatient ,  and outpatient  rehabilitation. Firstly, survivors may demonstrate improvements in both capacity and performance after stroke. Secondly, survivors may demonstrate an improvement in capacity but not performance. Lastly, survivors may demonstrate little or no change in both capacity and performance. An improvement in performance but not capacity has not been documented in the literature. Combined, these profiles support our rationale that UL capacity and performance are interrelated, yet are different constructs that must be measured separately.
Stroke recovery is a long-term goal. It is important to complete observational studies that track recovery to establish whether there is a discrepancy between capacity and performance in the long-term. To date, longitudinal tracking of recovery has largely lacked investigation of natural recovery from an acute time point post-stroke (first 7- to 14-days), long-term follow up of patients beyond 3- to 6-months post-stroke, and characterisation of stroke variables such as lesion type and location that may modify or interact with observed recovery profiles .
In this exploratory study our objectives were to determine 1) whether UL capacity and performance improve over the first 24-months after stroke; and 2) if there is a window of greatest improvement in UL capacity and performance. This information is important to develop an understanding of the longterm timecourse of recovery after stroke to support evidence-based clinical practice guidelines to inform upper limb rehabilitation services.