My nonuse of my left side is very specifically because MY DOCTOR DID NOTHING IN THE FIRST WEEK TO STOP THE NEURONAL CASCADE OF DEATH. Causing 5.4 billion neurons to die. It has nothing to do with nonuse, it is not possible to move it. Blame the correct persons for nonuse, the doctors.
Quantifying Nonuse in Chronic Stroke Patients: A Study Into Paretic, Nonparetic, and Bimanual Upper-Limb Use in Daily Life
Marian E. Michielsen, MSc†
, Ruud W. Selles, PhD, Henk J. Stam, MD, PhD Gerard M. Ribbers, MD, PhD, Johannes B. Bussmann, PhD
ABSTRACT. Michielsen ME, Selles RW, Stam HJ, RibbersGM, Bussmann JB. Quantifying nonuse in chronic stroke pa-tients: a study into paretic, nonparetic, and bimanual upper-limb use in daily life. Arch Phys Med Rehabil 2012;xx:xxx.
Objective:
To quantify uni- and bimanual upper-limb use inpatients with chronic stroke in daily life compared with healthy controls.
Design:
Cross-sectional observational study.
Setting:
Outpatient rehabilitation center.
Participants:
Patients with chronic stroke (n=38) and healthycontrols (n=18).
Intervention:
Not applicable.
Main Outcome Measures:
Upper-limb use in daily life was measured with an accelerometry based upper-limb activity monitor, an accelerometer based measurement device. Uni-manual use of the paretic and the nonparetic side and bimanual upper-limb use were measured for a period of 24 hours. Out-comes were expressed in terms of both duration and intensity.
Results:
Patients used their unaffected limb much more than their affected limb (5.3h vs 2.4h), while controls used both limbs a more equal amount of time (5.4h vs 5.1h). Patients used their paretic side less than controls used their non dominant side and their non paretic side more than controls their dominantside. The intensity with which patients used their paretic side was lower than that with which controls used their non dominant side, while that of the non paretic side was higher than that of the dominant side of controls. Finally, patients used their paretic side almost exclusively in bimanual activities. During bimanual activities, the intensity with which they used their affected side was much lower than that of the non affected side.
Conclusion:
Our data show considerable nonuse of the paretic side, both in duration and in intensity, and both during unimanual and bimanual activities in patients with chronic stroke. Patients do compensate for this with increased use of the non paretic side.
Key Words:
Ambulatory monitoring; Motor activity; Reha-bilitation; Stroke; Upper extremity.©
2012 by the American Congress of Rehabilitation Medicine
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