The relationship between Rating of Everyday Arm-use in the Community and Home (REACH) scale affected arm-use assessment, activity and participation after stroke.

Abstract

While arm function has been traditionally used as a primary goal for upper extremity rehabilitation post-stroke, we propose a simple measure of arm use, which may translate into better activities and participation. The aim was to determine the relationship between arm use and measures of activity and participation. This was a cross-sectional study with evaluative components involving community-dwelling individuals with chronic stroke. The Rating of Everyday Arm-Use in the Community and Home (REACH) Scale was used to assess affected arm use, Barthel Index and activity domain of the Stroke Impact Scale (SIS) for activities, and participation domain of the SIS for participation. The participants were also asked if they resumed driving after the stroke. Forty-nine individuals (mean age=70.3±11.5years, male sex=51%) living with the effects of a stroke for at least 3months participated in this study. There was a positive relationship between affected arm use and activities (Barthel Index score - rs =0.464; SIS activities - rs =0.686), participation (rs =0.479), and driving (rs =0.581). The Barthel Index scores were higher for individuals with dominant arm hemiparesis (p=0.003) or left hemisphere lesions (p=0.005). There was also greater arm use in left hemisphere lesions (p=0.018). Affected arm use in individuals with chronic stroke is related to activities and participation. Given the importance of arm use in activities and participation after stroke, rehabilitation therapists may consider utilizing the REACH Scale, a simple and quick outcome measure, as a means to assess arm use and implement effective interventions for improving arm use.