Rehabilitation Effort to Improve Upper Extremity Function in Post-Stroke Patients: A Meta-Analysis

The aim: Was to determine the relations between the the upper extremity function and cognition in post-stroke patients. Materials and methods: Totally there were 86 patients examined in the 1-year period after first-ever anterior circulation ischemic stroke. Examination of the upper extremity function was performed with the Fugl-Meyer assessment (FMA). Cognitive function was assessed with the Mini Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Frontal Assessment Battery (FAB), Trail-making Test A and B (TMT) and the Clock Drawing Test (CDT). Results: Motor dysfunction mostly manifested in low “Wrist” and “Hand” subtests scores (5 and 7 , respectively) and therefore resulted in decreased “Total motor function” score of 40 . The most significant relations were found out between the FMA “Hand”, “Total motor function” subtests and CI indices. MoCA score correlated with FMA “Wrist” (r=0.34; p=0.021), “Hand” (r=0.52; p=0.001) and “Total motor function” (r=0.48; p=0.003) scores. “Hand” score also correlated with the FAB (r=0.43; p=0.012), CDT (r=0.22; p=0.016), TMT-A (r=-0.31; p=0.023) and TMT-B (-0.48; p=0.009) scores. There was no significant correlation between the sensory FMA subtests. Conclusion: Our findings suggest that upper extremity motor impairment, especially hand and wrist dysfunction, are associated with cognitive impairment and executive functions disorder in particular.

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Treatment With Botulinum Toxin Improves Upper-Extremity Function Post Stroke: A Systematic Review and Meta-Analysis

Archives of Physical Medicine and Rehabilitation ◽

10.1016/j.apmr.2012.12.006 ◽

2013 ◽

Vol 94 (5) ◽

pp. 977-989 ◽

Cited By ~ 60

Author(s):

Norine Foley ◽

Shelialah Pereira ◽

Katherine Salter ◽

Manuel Murie Fernandez ◽

Mark Speechley ◽

...

Keyword(s):

Systematic Review ◽

Botulinum Toxin ◽

Upper Extremity ◽

Meta Analysis ◽

Post Stroke ◽

Extremity Function ◽

Upper Extremity Function

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Effectiveness of self-administered mirror therapy on upper extremity impairments and function of acute stroke patients: study protocol

Trials ◽

10.1186/s13063-021-05380-9 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Venkadesan Rajendran ◽

Deepa Jeevanantham ◽

Céline Larivière ◽

Ravinder-Jeet Singh ◽

Lisa Zeman ◽

...

Keyword(s):

Acute Stroke ◽

Upper Extremity ◽

Outcome Measure ◽

Outcome Evaluation ◽

Secondary Outcome ◽

Mirror Therapy ◽

Stroke Patients ◽

Extremity Function ◽

Upper Extremity Function ◽

Experimental Group

Abstract Background Many therapeutic interventions are performed by physiotherapists to improve upper extremity function and/or activities of daily living (ADL) in stroke patients. Mirror therapy (MT) is a simple technique that can be self-administered by the patients with intact cognition following patient education by a skilled physiotherapist. However, the effectiveness of self-administered MT in post-stroke patients in upper extremity function remains unclear. Therefore, the objective of this study is to examine the effectiveness of MT in improving upper extremity function and recovery in acute stroke patients. Methods This study is a single-center, prospective, randomized, open-label, controlled trial with blinded outcome evaluation (PROBE design), in which a total of 36 eligible acute stroke patients will be randomly assigned to control (n=18) and experimental group (n=18). Participants in the control group will receive regular rehabilitation interventions whereas participants in the experimental group will receive MT education in addition to their regular interventions for 4 weeks. Study outcome The primary outcome measure will be upper extremity function that will be measured using the Fugl-Meyer Assessment scale and the Wolf Motor Function Test. The secondary outcome measure will be behaviors related to ADL as estimated using the Modified Barthel Index. Outcome measures will be assessed at baseline and at 4 weeks post-rehabilitation intervention/MT. Results A two-way repeated analysis of variance (ANOVA) with time and group effects will be used to analyze between-group differences. The level of significance will be set at P < 0.05. Conclusion The results of the study will provide critical information to include self-administered MT as an adjuvant to regular interventions and may facilitate recovery of the upper extremity function of stroke patients. Trial registration ClinicalTrials.gov NCT04542772. Registered on 9 September 2020. Protocol version: Final 1.0.

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Abstract 2580: How Frequent Is Impaired Arm And Hand Function After First Occasion Of Stroke? An Unselected Population From A Stroke Unit With A Geographical Catchment.

Stroke ◽

10.1161/str.43.suppl_1.a2580 ◽

2012 ◽

Vol 43 (suppl_1) ◽

Author(s):

Katharina Stibrant Sunnerhagen ◽

Hanna C Persson

Keyword(s):

Upper Extremity ◽

Stroke Unit ◽

Catchment Area ◽

Hand Function ◽

Stroke Onset ◽

Stroke Patients ◽

Extremity Function ◽

Unselected Population ◽

Upper Extremity Function ◽

Impaired Motor Function

Introduction Reduced upper extremity function after stroke has previously been reported in 70-80% of patients with stroke in the acute stage and is one of the most common impairments after acute stroke impaired motor function, both in upper and lower extremity, influence the stroke unit care and planning of the rehabilitation, partly due to the economic costs. There is limited information in upper extremity function within the first days after a stroke. Prior studies include either both first and recurrent stroke or only one type of stroke. Objectives To investigate the frequency impaired arm and hand function in an unselected group of patients with first occasion of stroke. Method All patients at a stroke unit at Sahlgrenska University Hospital were assessed during 18 months. From the hospital records, the patients were identified, the patient charts were read and first stroke diagnosis was confirmed (by either imaging or clinical assessment). Impaired upper extremity function was defined in the following manner: assessed with the Modified Motor Assessment Scale (M-MAS UAS -95) by physiotherapist working at the stroke unit within 72 hours after stroke onset or if this was found in the patients chart, other standardized assessments of upper extremity function performed by the physical therapist, the occupational therapist or the physicians on the ward. Results During the study period 984 patients with first ever stroke (438 women 44.5%) were admitted to the stroke unit. A total of 213 patients were not at the stroke unit within 72 hours after onset and therefore excluded; 90 patients had unclear stroke onset time, 49 patients were located at another ward, 36 patients were in the intensive care unit, 25 in other hospitals in Sweden and 12 patients were hospitalized in another country. There were 771 patients over 18 years old at the stroke unit within 72 hours after stroke onset. Of these 56 patients (7.3%), were not living in the catchment area and therefore excluded. Of the 715 patients living in the geographical catchment area, 58, (8.1%) hade other upper extremity injury prior the stroke onset. Of the remaining first ever stroke patients (n=657), 311 patients (47.3%) hade impaired arm and hand function within 72 hours after stroke onset. Conclusion The frequency of impaired upper extremity function in this unselected population of first occasion of stroke is lower than previously reported. The Copenhagen stroke study noted 69 % impaired at admission and 43 % at one week. This indicates that today’s stroke patients present less frequent with impaired motor function in the upper extremity. However, they may have difficulties in functional activities which may influence content of rehabilitation process.

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