Useless, maybe if your research had been 'fixing the nonuse in chronic patients'. For this crapola, you're fired! My nonuse is all because of spasticity. CURE SPASTICITY and I'll recover in no time! 10 years later and stroke survivors are no better off for this problem. All because stroke researchers aren't even trying to solve stroke!
Quantifying Nonuse in Chronic Stroke Patients: A Study Into Paretic, Nonparetic, and Bimanual Upper-Limb Use in Daily Life
2012, Archives of Physical Medicine and Rehabilitation
Marian E. Michielsen, MSc†, Ruud W. Selles, PhD, Henk J. Stam, MD, PhD Gerard M. Ribbers, MD, PhD,
Johannes B. Bussmann, PhD
ABSTRACT. Michielsen ME, Selles RW, Stam HJ, Ribbers
GM, Bussmann JB. Quantifying nonuse in chronic stroke pa-
tients: a study into paretic, nonparetic, and bimanual upper-
limb use in daily life. Arch Phys Med Rehabil 2012;xx:xxx.
Objective: To quantify uni- and bimanual upper-limb use in
patients with chronic stroke in daily life compared with healthy
controls.
Design: Cross-sectional observational study.
Setting: Outpatient rehabilitation center.
Participants: Patients with chronic stroke (n38) and healthy
controls (n18).
Intervention: Not applicable.
Main Outcome Measures: Upper-limb use in daily life was
measured with an accelerometry-based upper-limb activity
monitor, an accelerometer based measurement device. Uni-
manual use of the paretic and the nonparetic side and bimanual
upper-limb use were measured for a period of 24 hours. Out-
comes were expressed in terms of both duration and intensity.
Results: Patients used their unaffected limb much more than
their affected limb (5.3h vs 2.4h), while controls used both
limbs a more equal amount of time (5.4h vs 5.1h). Patients used
their paretic side less than controls used their nondominant side
and their nonparetic side more than controls their dominant
side. The intensity with which patients used their paretic side
was lower than that with which controls used their nondomi-
nant side, while that of the nonparetic side was higher than that
of the dominant side of controls. Finally, patients used their
paretic side almost exclusively in bimanual activities. During
bimanual activities, the intensity with which they used their
affected side was much lower than that of the nonaffected side.
Conclusion: Our data show considerable nonuse of the pa-
retic side, both in duration and in intensity, and both during
unimanual and bimanual activities in patients with chronic
stroke. Patients do compensate for this with increased use of
the nonparetic side.
Johannes B. Bussmann, PhD
ABSTRACT. Michielsen ME, Selles RW, Stam HJ, Ribbers
GM, Bussmann JB. Quantifying nonuse in chronic stroke pa-
tients: a study into paretic, nonparetic, and bimanual upper-
limb use in daily life. Arch Phys Med Rehabil 2012;xx:xxx.
Objective: To quantify uni- and bimanual upper-limb use in
patients with chronic stroke in daily life compared with healthy
controls.
Design: Cross-sectional observational study.
Setting: Outpatient rehabilitation center.
Participants: Patients with chronic stroke (n38) and healthy
controls (n18).
Intervention: Not applicable.
Main Outcome Measures: Upper-limb use in daily life was
measured with an accelerometry-based upper-limb activity
monitor, an accelerometer based measurement device. Uni-
manual use of the paretic and the nonparetic side and bimanual
upper-limb use were measured for a period of 24 hours. Out-
comes were expressed in terms of both duration and intensity.
Results: Patients used their unaffected limb much more than
their affected limb (5.3h vs 2.4h), while controls used both
limbs a more equal amount of time (5.4h vs 5.1h). Patients used
their paretic side less than controls used their nondominant side
and their nonparetic side more than controls their dominant
side. The intensity with which patients used their paretic side
was lower than that with which controls used their nondomi-
nant side, while that of the nonparetic side was higher than that
of the dominant side of controls. Finally, patients used their
paretic side almost exclusively in bimanual activities. During
bimanual activities, the intensity with which they used their
affected side was much lower than that of the nonaffected side.
Conclusion: Our data show considerable nonuse of the pa-
retic side, both in duration and in intensity, and both during
unimanual and bimanual activities in patients with chronic
stroke. Patients do compensate for this with increased use of
the nonparetic side.
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