scholarly journals Remote evaluation of upper extremity motor function following stroke: The Arm Capacity and Movement Test (ArmCAM) (Preprint)

10.2196/26044 ◽  
2020 ◽  
Author(s):  
Chieh-Ling Yang ◽  
Lisa A. Simposon ◽  
Janice Eng
Keyword(s):  
Upper Extremity ◽  
Motor Function ◽  
Movement Test ◽  
Remote Evaluation

Remote evaluation of upper extremity motor function following stroke: The Arm Capacity and Movement Test (ArmCAM) (Preprint)

2020 ◽  
Author(s):  
Chieh-Ling Yang ◽  
Lisa A. Simposon ◽  
Janice Eng
Keyword(s):  
Upper Extremity ◽  
Motor Function ◽  
Intraclass Correlation ◽  
Reliability And Validity ◽  
Correlation Coefficients ◽  
Minimal Detectable Change ◽  
Special Equipment ◽  
Good Reliability ◽  
Rater Reliability ◽  
Movement Test

BACKGROUND Developing a simple measure that can be administered remotely via videoconferencing is needed for telerehabilitation for rural and remote population, or during the COVID-19 pandemic. OBJECTIVE To develop a valid and reliable measure [the Arm Capacity and Movement Test (ArmCAM)] administered remotely via videoconferencing to evaluate upper extremity motor function after stroke. METHODS A sample of individuals with stroke (N=31) was used to assess the reliability and validity of the ArmCAM (range: 0-30). Test-retest and inter-rater reliability were assessed through the intraclass correlation coefficients (ICC), standard error of measurement (SEM) and minimal detectable change (MDC). Validity was examined by the Pearson and Spearman rank correlation coefficients. RESULTS The ArmCAM consists of 10 items and takes 15 minutes to administer without any special equipment except for a computer and internet access. The ICC for test-retest reliability and inter-rater reliability were 0.997 and 0.993, respectively. The SEM and MDC95 were 0.74 and 2.05 points, respectively. With respect to validity, correlations between the ArmCAM and the Rating of Everyday Arm-use in the Community and Home Scale, Stroke Impact Scale-Hand, Fugl-Meyer Assessment for upper extremity, and Action Research Arm Test were good to excellent (correlation coefficients: 0.811-0.944). CONCLUSIONS he ArmCAM has good reliability and validity. It is an easy-to-use assessment that is designed to be administered remotely via video conferencing. CLINICALTRIAL NA (This is not a clinical trial)

scholarly journals Predictors of Clinically Important Improvements in Motor Function and Daily Use of Affected Arm after a Botulinum Toxin A Injection in Patients with Chronic Stroke

Toxins ◽  
2021 ◽  
Vol 14 (1) ◽  
pp. 13
Author(s):  
Jen-Wen Hung ◽  
Wen-Chi Wu ◽  
Yi-Ju Chen ◽  
Ya-Ping Pong ◽  
Ku-Chou Chang
Keyword(s):  
Botulinum Toxin ◽  
Upper Extremity ◽  
Motor Function ◽  
Botulinum Toxin A ◽  
Change Score ◽  
Toxin A ◽  
Injection Duration ◽  
Active Motor ◽  
Quality Of Movement

Identifying patients who can gain minimal clinically important difference (MCID) in active motor function in the affected upper extremity (UE) after a botulinum toxin A (BoNT-A) injection for post-stroke spasticity is important. Eighty-eight participants received a BoNT-A injection in the affected UE. Two outcome measures, Fugl–Meyer Assessment Upper Extremity (FMA-UE) and Motor Activity Log (MAL), were assessed at pre-injection and after 24 rehabilitation sessions. We defined favorable response as an FMA-UE change score ≥5 or MAL change score ≥0.5.Statistical analysis revealed that the time since stroke less than 36 months (odds ratio (OR) = 4.902 (1.219–13.732); p = 0.023) was a significant predictor of gaining MCID in the FMA-UE. Medical Research Council scale -proximal UE (OR = 1.930 (1.004–3.710); p = 0.049) and post-injection duration (OR = 1.039 (1.006–1.074); p =0.021) were two significant predictors of MAL amount of use. The time since stroke less than 36 months (OR = 3.759 (1.149–12.292); p = 0.028), naivety to BoNT-A (OR = 3.322 (1.091–10.118); p = 0.035), and education years (OR = 1.282 (1.050–1.565); p = 0.015) were significant predictors of MAL quality of movement. The findings of our study can help optimize BoNT-A treatment planning.

Abstract 144: Forced Aerobic Exercise Enhances Upper Extremity Task Practice in Patients with Stroke

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Susan Linder ◽  
Anson Rosenfeldt ◽  
Jay Alberts
Keyword(s):  
Aerobic Exercise ◽  
Upper Extremity ◽  
Motor Function ◽  
Cardiovascular Health ◽  
Statistical Significance ◽  
Voluntary Exercise ◽  
Depressive Symptomology ◽  
Task Practice ◽  
The Central Nervous System ◽  
Minute Session

Introduction: Aerobic exercise (AE) has been shown to improve cardiovascular health in individuals with stroke; however, the potential role of AE in enhancing neuroplasticity after stroke has not been systematically studied. We have implemented a forced exercise (FE) cycling intervention, initially developed for individuals with Parkinson’s disease, with a cohort of individuals with chronic stroke. We hypothesize that intensive AE training, when paired with repetitive task practice (RTP), will “prime” the central nervous system, to exploit the motor learning effects of task practice. Hypothesis: Individuals who perform FE followed by RTP will demonstrate greater improvements in motor and non-motor function compared to the voluntary rate aerobic exercise (VE) + RTP and RTP only groups. Individuals in both AE groups (FE and VE) will demonstrate greater improvements in VO2peak compared to the RTP only group. Methods: Fifteen individuals 6-12 months post-stroke were enrolled into one of the following groups: 1) Forced Exercise + RTP (FE + RTP); 2) Voluntary Exercise + RTP (VE + RTP); and 3) Time-matched RTP. Participants in the AE groups completed one 45-minute session of stationary cycling followed immediately by one 45-minute session of upper extremity RTP; however, the rate of cycling for the FE group was augmented to approximately 35% faster than their voluntary rate. All participants completed a total of 24 exercise sessions over an 8-week period. Results: While all three groups made significant improvements in motor function as measured by the Fugl-Meyer Assessment (p=.03), the FE+RTP group exceeded the VE+RTP and RTP only groups, approaching statistical significance (p=0.06), despite the two AE groups completing 44% less RTP practice time than the RTP group. Improvements in self-reported quality of life and depressive symptomology also improved across all three groups, with trends favoring the FE group. VO2peak improved by 1.1 and 2.68 mL/kg/min for the FE+RTP and VE+RTP groups, respectively; while VO2peak decreased by 0.85mL/kg/min in the RTP group. Conclusion: FE + RTP is a promising intervention to enhance motor and non-motor function, in addition to aerobic capacity in individuals 6-12 months after stroke.

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