Association between self-perceived activity performance and upper limb functioning in subacute stroke

Abstract

Background and purpose: This study aimed to investigate to what extent upper limb (UL) motor impairment, trunk compensation, and activity performance are related to self-perception of UL activity performance in subacute stroke.

Methods: This was a prospective observational study. Twenty-four adults with subacute stroke (age: 65.4 ± 10.8 years) underwent clinical and kinematic assessments at baseline (33.9 ± 5.2 days after stroke onset) and 4 weeks after the baseline. The clinical assessment included the UL Fugl-Meyer motor assessment (FMA), Simple Test for Evaluating hand Function (STEF), and the performance and satisfaction scores of the Canadian Occupational Performance Measure (COPM). The kinematic measurement was performed using a motion capture system during a standardized reach-to-grasp task. Endpoint performance variables and trunk displacement were calculated as kinematic outcomes. An inpatient rehabilitation program of 3 h/day was provided every day for 4 weeks between the two measurement points. The relationships between COPM scores and clinical/kinematic outcomes were examined by multiple regression analysis. Significance levels of p < 0.05 were used.

Results: The results of the multiple regression analysis showed that the changes in STEF (β = 0.520, p = 0.005) and trunk compensation (β = -0.398, p = 0.024) were moderately related to the change in the COPM satisfaction (R² _adj = 0.426, p = 0.001), while the change in UL FMA was not.

Discussion: The changes in activity performance and trunk compensation were related to improved self-perception of UL activity performance. Therapeutic management for activity performance and trunk compensation may be important for improving self-perception of UL activity performance after stroke.

Keywords: compensation; kinematics; rehabilitation; stroke; upper limb.