Does Task-Specific Training Improve Upper Limb Performance in Daily Life Poststroke?.

MedStar author(s):
Citation: Neurorehabilitation & Neural Repair. 31(3):290-300, 2017 MarPMID: 27909071Institution: MedStar National Rehabilitation NetworkForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Activities of Daily Living | *Exercise Therapy | *Stroke Rehabilitation | *Stroke/pp [Physiopathology] | *Upper Extremity/pp [Physiopathology] | Accelerometry | Female | Humans | Linear Models | Male | Middle Aged | Paresis/pp [Physiopathology] | Paresis/rh [Rehabilitation] | Single-Blind Method | Treatment OutcomeYear: 2017Local holdings: Available online from MWHC library: 2006 - 2009, Available in print through MWHC library: 1999 - March 2006ISSN:
  • 1545-9683
Name of journal: Neurorehabilitation and neural repairAbstract: BACKGROUND: 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.CONCLUSIONS: Improved motor capacity resulting from an intensive outpatient UL intervention does not appear to translate to increased UL performance outside the clinic.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.OBJECTIVE: To examine changes in UL performance after an intensive, individualized, progressive, task-specific UL intervention for individuals at least 6 months poststroke.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.All authors: Bailey RR, Birkenmeier RL, Dromerick AW, Klaesner JW, Lang CE, Strube MJ, Waddell KJFiscal year: FY2017Digital Object Identifier: Date added to catalog: 2017-05-06
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Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 27909071 Available 27909071

Available online from MWHC library: 2006 - 2009, Available in print through MWHC library: 1999 - March 2006

BACKGROUND: 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.

CONCLUSIONS: Improved motor capacity resulting from an intensive outpatient UL intervention does not appear to translate to increased UL performance outside the clinic.

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.

OBJECTIVE: To examine changes in UL performance after an intensive, individualized, progressive, task-specific UL intervention for individuals at least 6 months poststroke.

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.

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