Plateau is a failure of your doctors and therapists, not you. Don't allow that word to be uttered in your presence. I would start screaming at them asking how long they have known of these plateaus and done nothing. You can't let incompetence interfere with your recovery, although you are screwed, but if your doctors and therapists start right now they might have solutions for your children and grandchildren's stroke. Up to you, let sleeping dogs lie or get stroke solved.
Upper Limb Performance in Daily Life Approaches Plateau Around Three to Six Weeks Post-stroke
Abstract
Background.
Wearable sensors allow for direct measurement of upper limb (UL) performance in daily life.
Objective.
To map the trajectory of UL performance and its relationships to other factors post-stroke.
Methods.
Participants (n = 67) with first stroke and UL paresis were assessed at 2, 4, 6, 8, 12, 16, 20, and 24 weeks after stroke. Assessments captured UL impairment (Fugl-Meyer), capacity for activity (Action Research Arm Test), and performance of activity in daily life (accelerometer variables of use ratio and hours of paretic limb activity), along with other potential modifying factors. We modeled individual trajectories of change for each measurement level and the moderating effects on UL performance trajectories.
Results.
Individual trajectories were best fit with a 3-parameter logistic model, capturing the rapid growth early after stroke within the longer data collection period. Plateaus (90% of asymptote) in impairment (bootstrap mean ± SE: 32 ± 4 days post-stroke) preceded those in capacity (41 ± 4 days). Plateau in performance, as measured by the use ratio (24 ± 5 days), tended to precede plateaus in impairment and capacity. Plateau in performance, as measured by hours of paretic activity (41 ± 6 days), occurred at a similar time to that of capacity and slightly lagged impairment. Modifiers of performance trajectories were capacity, concordance, UL rehabilitation, depressive symptomatology, and cognition.
Conclusions.
Upper limb performance in daily life approached plateau 3 to 6 weeks post-stroke. Individuals with stroke started to achieve a stable pattern of UL use in daily life early, often before neurological impairments and functional capacity started to stabilize.
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