WHAT FUCKING STUPIDITY! PREDICTIONS NOT RECOVERY!
Kinematic measures of Arm-trunk movements during unilateral and bilateral reaching predict clinically important change in perceived arm use in daily activities after intensive stroke rehabilitation
Published 2015
RESEARCH Open Access
Kinematic measures of Arm-trunk movements during unilateral and bilateral reaching predict clinically important change in perceived arm use in daily activities after intensive stroke rehabilitation
Hao-ling Chen
1,2
, Keh-chung Lin
1,2
, Rong-jiuan Liing
3
, Ching-yi Wu
3,4*
and Chia-ling Chen
5
Kinematic analysis has been used to objectively evaluate movement patterns, quality, and strategies during reaching tasks. However, no study has investigated whether kinematic variables during unilateral and bilateral reaching tasks predict a patient’s perceived arm use during activities of daily living (ADL) after an intensive intervention. Therefore, this study investigated whether kinematic measures during unilateral and bilateral reaching tasks before an intervention can predict clinically meaningful improvement in perceived arm use during ADL after intensive post stroke rehabilitation.
Methods:
The study was a secondary analysis of 120 subjects with chronic stroke who received 90–120 min. of intensive intervention every weekday for 3-4 weeks. Reaching kinematics during unilateral and bilateral tasks and the Motor Activity Log (MAL) were evaluated before and after the intervention.
Results:
Kinematic variables explained 22 and 11 % of the variance in actual amount of use (AOU) and quality of movement (QOM), respectively, of MAL improvement during unilateral reaching tasks. Kinematic variables also explained 21 and 31 % of the variance in MAL-AOU and MAL-QOM, respectively, during bilateral reaching tasks. Selected kinematic variables, including endpoint variables, trunk involvement, and joint recruitment and interjoint coordination, were significant predictors for improvement in perceived arm use during ADL (P < 0.05).
Conclusions:
Arm
–
trunk kinematics may be used to predict clinically meaningful improvement in perceived arm use during ADL after intensive rehabilitation. Involvement of interjoint coordination and trunk controlvariables as predictors in bilateral reaching models indicates that a high level of motor control (i.e., multijoint coordination) and trunk stability may be important in obtaining treatment gains in arm use, especially for bilateral daily activities, in intensive rehabilitation after stroke.
Keywords:
Kinematics, Reaching, Stroke, Clinically important change, Daily function
* Correspondence: cywu@mail.cgu.edu.tw
3
Department of Occupational Therapy and Graduate Institute of BehavioralSciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
4
Healthy Ageing Research Center, Chang Gung University, Taoyuan, Taiwan Full list of author information is available at the end of the article
JNER
JOURNAL OF NEUROENGINEERING AND REHABILITATION
© 2015 Chen et al.
Open Access
This article is distributed under the terms of the Creative Commons Attribution 4.0International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver(http://creativecommons.org/publicdomain/zero/1.0/ ) applies to the data made available in this article, unless otherwise stated.
Chen
et al. Journal of NeuroEngineering and Rehabilitation
(2015) 12:84
DOI 10.1186/s12984-015-0075-8
RESEARCH Open Access
Kinematic measures of Arm-trunk movements during unilateral and bilateral reaching predict clinically important change in perceived arm use in daily activities after intensive stroke rehabilitation
Hao-ling Chen
1,2
, Keh-chung Lin
1,2
, Rong-jiuan Liing
3
, Ching-yi Wu
3,4*
and Chia-ling Chen
5
Abstract
Background:Kinematic analysis has been used to objectively evaluate movement patterns, quality, and strategies during reaching tasks. However, no study has investigated whether kinematic variables during unilateral and bilateral reaching tasks predict a patient’s perceived arm use during activities of daily living (ADL) after an intensive intervention. Therefore, this study investigated whether kinematic measures during unilateral and bilateral reaching tasks before an intervention can predict clinically meaningful improvement in perceived arm use during ADL after intensive post stroke rehabilitation.
Methods:
The study was a secondary analysis of 120 subjects with chronic stroke who received 90–120 min. of intensive intervention every weekday for 3-4 weeks. Reaching kinematics during unilateral and bilateral tasks and the Motor Activity Log (MAL) were evaluated before and after the intervention.
Results:
Kinematic variables explained 22 and 11 % of the variance in actual amount of use (AOU) and quality of movement (QOM), respectively, of MAL improvement during unilateral reaching tasks. Kinematic variables also explained 21 and 31 % of the variance in MAL-AOU and MAL-QOM, respectively, during bilateral reaching tasks. Selected kinematic variables, including endpoint variables, trunk involvement, and joint recruitment and interjoint coordination, were significant predictors for improvement in perceived arm use during ADL (P < 0.05).
Conclusions:
Arm
–
trunk kinematics may be used to predict clinically meaningful improvement in perceived arm use during ADL after intensive rehabilitation. Involvement of interjoint coordination and trunk controlvariables as predictors in bilateral reaching models indicates that a high level of motor control (i.e., multijoint coordination) and trunk stability may be important in obtaining treatment gains in arm use, especially for bilateral daily activities, in intensive rehabilitation after stroke.
Keywords:
Kinematics, Reaching, Stroke, Clinically important change, Daily function
* Correspondence: cywu@mail.cgu.edu.tw
3
Department of Occupational Therapy and Graduate Institute of BehavioralSciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
4
Healthy Ageing Research Center, Chang Gung University, Taoyuan, Taiwan Full list of author information is available at the end of the article
JNER
JOURNAL OF NEUROENGINEERING AND REHABILITATION
© 2015 Chen et al.
Open Access
This article is distributed under the terms of the Creative Commons Attribution 4.0International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver(http://creativecommons.org/publicdomain/zero/1.0/ ) applies to the data made available in this article, unless otherwise stated.
Chen
et al. Journal of NeuroEngineering and Rehabilitation
(2015) 12:84
DOI 10.1186/s12984-015-0075-8
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