Abstract
Background.
Upper limb (UL) performance, or use, in daily life is complex and
likely influenced by many factors. While the recovery trajectory of UL
impairment poststroke is well documented, little is known about the
recovery trajectory of sensor-measured UL performance in daily life
early after stroke and the potential moderating role of psychosocial
factors.
Objective. To examine the recovery trajectory of UL
performance within the first 12 weeks poststroke and characterize the
potential moderating role of belief, confidence, and motivation on UL
performance.
Methods. This was a longitudinal, prospective cohort
study quantifying UL performance and related psychosocial factors early
after stroke. UL performance was quantified via bilateral, wrist-worn
accelerometers over 5 assessment sessions for 24 hours. Belief,
confidence, and motivation to use the paretic UL, and self-perceived
barriers to UL recovery were quantified via survey. Change in 4
accelerometer variables and the moderating role of psychosocial factors
was tested using hierarchical linear modeling. The relationship between
self-perceived barriers and UL performance was tested via Spearman
rank-order correlation analysis.
Results. UL performance improved
over the first 12 weeks after stroke. Belief, confidence, and
motivation did not moderate UL performance over time. There was a
negative relationship between UL performance and self-perceived barriers
to UL recovery at week 2, which declined over time. Conclusions.
Sensor-measured UL performance can improve early after stroke. Early
after stroke, rehabilitation interventions may not need to directly
target belief, confidence, and motivation but may instead focus on
reducing self-perceived barriers to UL recovery.
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