Well then, write up a protocol AND DELIVER IT to all 10 million yearly stroke survivors now and into the future on what works. But this is for chronic so deliver it to 80+ million stroke survivors in 2016. Just this writeup is totally fucking useless, doctors and stroke hospitals do not read and implement research.
Proximal Fugl-Meyer Assessment Scores Predict Clinically Important Upper Limb Improvement After Three Stroke Rehabilitative Interventions
Published 2015
M A N U S C R I P A C C E P T E D
ACCEPTED MANUSCRIPT
Running Head: Identify appropriate therapy for stroke
Proximal Fugl-Meyer Assessment Scores Predict Clinically Important Upper Limb Improvement After Three Stroke Rehabilitative Interventions
Ya-yun Lee, PhD 1,2,
M A N U S C R I P A C C E P T E D
ACCEPTED MANUSCRIPT
Running Head: Identify appropriate therapy for stroke
Proximal Fugl-Meyer Assessment Scores Predict Clinically Important Upper Limb Improvement After Three Stroke Rehabilitative Interventions
Ya-yun Lee, PhD 1,2,
Yu-wei Hsieh, PhD 1,2,
Ching-yi Wu, ScD 1,2,
Keh-chung Lin, ScD 3,
Chih-kuang Chen, MD 4,5**
Ya-yun Lee and Yu-wei Hsieh are joint first-authors.**
1 Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
2 Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
3 School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
4 Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Taoyuan, Taoyuan, Taiwan
5 School of Medicine, Chang Gung University, Taoyuan, Taiwan
Acknowledgement
This study was partly supported by grants from the National Health Research Institutes (NHRI-EX103-10010PI), the Ministry of Science and Technology (MOST 103-2314-B-182-002, MOST 103-2314-B-182-004-MY3, MOST 102-2314-B-002-154-MY2), the Healthy Aging Research Center at Chang Gung University (EMRPD1D0291, CMRPD1B0331), and Chang Gung Memorial Hospital (CMRPD 1C0402) in Taiwan.
Correspondence:
Keh-chung Lin, School of Occupational Therapy, College of Medicine, National Taiwan University, 17, F4, Xu Zhou Road, Taipei, Taiwan 100 Email: kehchunglin@ntu.edu.tw Telephone: +886-2-33668180 Fax: +886-2-23511331
Abstract Objective:
To identify the baseline motor characteristics of the patients who responded to 3 prominent intervention programs.
Design:
Observational cohort study.
Setting:
Outpatient rehabilitation clinics.
Participants:
Individuals with chronic stroke (N = 174).
Interventions:
Participants received 30 hours of constraint-induced movement therapy (CIMT), robot-assisted therapy (RT), or mirror therapy (MT).
Main Outcome Measure(s):
The primary outcome measure was the change score of the upper-extremity Fugl-Meyer Assessment (UE-FMA). The potential predicting variables were baseline proximal, distal, and total UE-FMA, and Action Research Arm Test scores. We combined polynomial regression analyses and the minimal clinically important difference to stratify the patients as responders and non-responders for each intervention approach.
Results:
The baseline proximal UE-FMA significantly predicted clinically important improvement on the primary outcome after all 3 interventions. Participants with baseline proximal UE-FMA scores approximately <30 benefited significantly from CIMT and RT, whereas participants with scores between 21 and 35 demonstrated significant improvements after MT. Baseline distal and total UE-FMA and Action Research Arm Test scores could also predict upper limb improvements after CIMT and MT but not after RT.
2 Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
3 School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
4 Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Taoyuan, Taoyuan, Taiwan
5 School of Medicine, Chang Gung University, Taoyuan, Taiwan
Acknowledgement
This study was partly supported by grants from the National Health Research Institutes (NHRI-EX103-10010PI), the Ministry of Science and Technology (MOST 103-2314-B-182-002, MOST 103-2314-B-182-004-MY3, MOST 102-2314-B-002-154-MY2), the Healthy Aging Research Center at Chang Gung University (EMRPD1D0291, CMRPD1B0331), and Chang Gung Memorial Hospital (CMRPD 1C0402) in Taiwan.
Correspondence:
Keh-chung Lin, School of Occupational Therapy, College of Medicine, National Taiwan University, 17, F4, Xu Zhou Road, Taipei, Taiwan 100 Email: kehchunglin@ntu.edu.tw Telephone: +886-2-33668180 Fax: +886-2-23511331
Abstract Objective:
To identify the baseline motor characteristics of the patients who responded to 3 prominent intervention programs.
Design:
Observational cohort study.
Setting:
Outpatient rehabilitation clinics.
Participants:
Individuals with chronic stroke (N = 174).
Interventions:
Participants received 30 hours of constraint-induced movement therapy (CIMT), robot-assisted therapy (RT), or mirror therapy (MT).
Main Outcome Measure(s):
The primary outcome measure was the change score of the upper-extremity Fugl-Meyer Assessment (UE-FMA). The potential predicting variables were baseline proximal, distal, and total UE-FMA, and Action Research Arm Test scores. We combined polynomial regression analyses and the minimal clinically important difference to stratify the patients as responders and non-responders for each intervention approach.
Results:
The baseline proximal UE-FMA significantly predicted clinically important improvement on the primary outcome after all 3 interventions. Participants with baseline proximal UE-FMA scores approximately <30 benefited significantly from CIMT and RT, whereas participants with scores between 21 and 35 demonstrated significant improvements after MT. Baseline distal and total UE-FMA and Action Research Arm Test scores could also predict upper limb improvements after CIMT and MT but not after RT.
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