Abstract
BackgroundRecovery patterns of motor function and activity capacity of the upper extremity after stroke have been described, but less is known about longitudinal changes of perceived manual activity performance. The aim of this study was to investigate longitudinal changes of self-perceived manual ability at several timepoints from onset until 12 months post-stroke in a cohort of consecutively recruited individuals with mild, moderate and severe stroke.MethodsThe study included 106 participants from a non-selected cohort with first-ever mild, moderate or severe stroke and impaired upper extremity function (Stroke Arm Longitudinal Study at the University of Gothenburg, SALGOT). Self-perceived manual ability was assessed with the ABILHAND Questionnaire at 3 and 10 days, 4 weeks, 3, 6 and 12 months after stroke. Longitudinal change was assessed by linear mixed models (fixed and random effects) and adjusted models were built by adding effects of cofactors age, gender, stroke severity, living condition and affected hand.ResultsSelf-perceived manual ability increased over time the first year after stroke for the total group and the subgroups. The final adjusted model for the total group included fix-effects of time (expected mean change 0.24 logits per month) adjusted by age (− 0.06 per year) and stroke severity (− 0.19 per NIHSS-score). In addition to significant effect of time, the adjusted models for moderate stroke subgroup included fixed effect of age, and for mild and severe subgroups there was an interaction effect between time and age. Further analyses between time-points showed that no significant change of self-perceived manual ability was detected beyond 3 months post-stroke.ConclusionsSelf-perceived manual ability increased over time the first year after stroke, and this change was to some degree modulated by age and stroke severity at onset. Most of the improvements occurred early, predominantly within the first three months after stroke.
Highlights
Recovery patterns of motor function and activity capacity of the upper extremity after stroke have been described, but less is known about longitudinal changes of perceived manual activity performance
There are recommendations of core measures after stroke [6] to be used such as the National Institutes of Health Stroke Scale (NIHSS) [7] to measure stroke severity, the Fugl-Meyer Assessment for Upper Extremity (FMA-UE) [8] to measure upper extremity impairments and Action Research Arm Test (ARAT) [9] to measure activity capacity limitations
Assessments of upper extremity motor function and activity capacity has been shown to be effective to measure recovery in the acute and early subacute stage post-stroke [16], but less is known about longitudinal changes of perceived manual activity performance
Summary
Recovery patterns of motor function and activity capacity of the upper extremity after stroke have been described, but less is known about longitudinal changes of perceived manual activity performance. The aim of this study was to investigate longitudinal changes of self-perceived manual ability at several timepoints from onset until 12 months post-stroke in a cohort of consecutively recruited individuals with mild, moderate and severe stroke. A remaining upper extremity impairment may negatively impact daily life and limit the ability to perform manual activities necessary for independent living [4]. Self-reported activity measures, such as the ABILHAND Questionnaire [11], provide important information of the performance of activities in daily life after stroke that is relevant from the perspective of the person [12]
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