Deans' stroke musings: Upper Limb Performance in Daily Life Improves Over the First 12 Weeks Poststroke

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Tuesday, September 10, 2019

Upper Limb Performance in Daily Life Improves Over the First 12 Weeks Poststroke

Well, DUH. You don't even use the proper term, spontaneous recovery.

Upper Limb Performance in Daily Life Improves Over the First 12 Weeks Poststroke

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Kimberly J. Waddell, PhD, Michael J Strube, PhD, Rachel G. Tabak, PhD, ...

First Published August 20, 2019 Research Article

Article Information

Volume: 33 issue: 10, page(s): 836-847

Article first published online: August 20, 2019; Issue published: October 1, 2019

Kimberly J. Waddell, PhD¹, Michael J Strube, PhD¹, Rachel G. Tabak, PhD¹, Debra Haire-Joshu, PhD¹,

Catherine E. Lang, PhD¹*

¹Washington University in St Louis, St Louis, MO, USA

Corresponding Author:

Catherine E. Lang, PhD, Program in Physical Therapy, Washington University in St Louis, Campus Box 8502, 4444 Forest Park Avenue, St Louis, MO 63108, USA. Email: langc@wustl.edu

*This author is a member of The American Society of Neurorehabilitation.

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.

Keywords stroke, accelerometry, upper limb, psychosocial, sensors, confidence