Will you stop predicting failure to recover and just do the GODDAMNED RESEARCH THAT GET SURVIVORS RECOVERED?
Potential Predictors of Motor and Functional Outcomes After Distributed Constraint-Induced Therapy for Patients With Stroke
2008, Neurorehabilitation and Neural Repair
Keh-chung Lin, ScD, OTR, Yan-hua Huang, PhD, OTR, Yu-wei Hsieh, MS, and Ching-yi Wu, ScD, OTR
Background
Selection of patients who are most and least likely to benefit from constraint-induced therapy (CIT) for the upper extremity is uncertain.
Objective
This study investigated demographic and clinical characteristics that may predict outcomes for a distributed form of CIT.
Methods
A group of 57 patients were treated with distributed CIT, and 7 potential predictors were identified, including age, sex, side of stroke, time since stroke, spasticity, neurologic status, and movement performance of the distal part of the upper extremity. Treatment outcome was assessed in terms of motor performance, perceived functional ability of the affected hand, and functional performance of daily activities, mea-sured by Fugl-Meyer Assessment (FMA), Motor Activity Log (MAL), and Functional Independence Measure (FIM), respectively.
Results
Motor ability of the distal part of the upper extremity and time since stroke were significantly predictive of outcomes on the FMA (adjusted R2 = 0.18,P = .002) and the MAL subtest quality of movement (adjusted R2 = 0.43,P < .0001). Motor ability and age were significant predictors of amount of use measured by the MAL (adjusted R2 = 0.20,P = .001). None of the variables exhibited a predictive relationship with the FIM.
Conclusions
The best predictor for motor outcomes after distributed CIT was greater motor ability of the distal part of the upper extremity, which is consistent with the presence of residual motor pathways that may respond to training. The FMA may be of value in stratifying patients for their likelihood to benefit from distributed CIT protocols.
Background
Selection of patients who are most and least likely to benefit from constraint-induced therapy (CIT) for the upper extremity is uncertain.
Objective
This study investigated demographic and clinical characteristics that may predict outcomes for a distributed form of CIT.
Methods
A group of 57 patients were treated with distributed CIT, and 7 potential predictors were identified, including age, sex, side of stroke, time since stroke, spasticity, neurologic status, and movement performance of the distal part of the upper extremity. Treatment outcome was assessed in terms of motor performance, perceived functional ability of the affected hand, and functional performance of daily activities, mea-sured by Fugl-Meyer Assessment (FMA), Motor Activity Log (MAL), and Functional Independence Measure (FIM), respectively.
Results
Motor ability of the distal part of the upper extremity and time since stroke were significantly predictive of outcomes on the FMA (adjusted R2 = 0.18,P = .002) and the MAL subtest quality of movement (adjusted R2 = 0.43,P < .0001). Motor ability and age were significant predictors of amount of use measured by the MAL (adjusted R2 = 0.20,P = .001). None of the variables exhibited a predictive relationship with the FIM.
Conclusions
The best predictor for motor outcomes after distributed CIT was greater motor ability of the distal part of the upper extremity, which is consistent with the presence of residual motor pathways that may respond to training. The FMA may be of value in stratifying patients for their likelihood to benefit from distributed CIT protocols.
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