Dataset Information

Proprioception deficits in chronic stroke-Upper extremity function and daily living.

ABSTRACT: Proprioception deficits are common post-stroke and predict poor functional outcome. It is unknown if the presence of proprioception deficits is negatively associated with the motor and functional ability of the affected upper extremity and daily living at the chronic stage post-stroke.1) To describe proprioception deficits of individuals with chronic stroke, 2) to correlate the severity of proprioception deficits with the motor and functional ability of the upper extremity, and 3) to compare independence in basic and instrumental activities in daily living (BADL, IADL), upper extremity motor and functional abilities between individuals with and without proprioception deficits.102 adults aged 29-85 years with chronic stroke participated in this cross sectional study. The upper extremity was assessed for proprioception (Thumb localization Test), motor [Fugl-Meyer Motor Assessment (FMA)] and functional ability [Action Research Arm Test (ARAT), Box and Block Test (BBT)], grip strength and daily use [Motor Activity Log (MAL)]. Independence in BADL and IADL was also assessed.71 participants had intact proprioception, 31 participants had mild-moderate proprioception deficits. Negative significant (p<.001) correlations were found between the severity of proprioception deficits to the motor ability (FMA) (r = -.41), functional ability (ARAT) (r = -.48), dexterity (BBT) (r = -.43), grip strength (r = -.41) and daily-use (MAL amount and quality) (r = -.55 and r = -.54, respectively) of the affected upper extremity. Significant between-group differences were found for BADL, IADL and upper extremity measures.Proprioception deficits of individuals with chronic stroke are negatively associated with upper extremity motor and functional abilities and independence in daily living. Therefore, proprioception should be assessed at the chronic stage post-stroke.

SUBMITTER: Rand D

PROVIDER: S-EPMC5877860 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Proprioception deficits in chronic stroke-Upper extremity function and daily living.

Rand Debbie D

PloS one 20180330 3

<h4>Background</h4>Proprioception deficits are common post-stroke and predict poor functional outcome. It is unknown if the presence of proprioception deficits is negatively associated with the motor and functional ability of the affected upper extremity and daily living at the chronic stage post-stroke.<h4>Aims</h4>1) To describe proprioception deficits of individuals with chronic stroke, 2) to correlate the severity of proprioception deficits with the motor and functional ability of the upper ...[more]

PMID: 29601594

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Project description:Percutaneous osseointegrated (OI) implants for direct skeletal attachment of upper extremity prosthetics represent an alternative to traditional socket suspension that may yield improved patient function and satisfaction. This is especially true in high-level, transhumeral amputees where prosthetic fitting is challenging and abandonment rates remain high. However, maintaining mechanical integrity of the bone-implant interface is crucial for safe clinical introduction of this technology. The collection of population data on the transhumeral loading environment will aid in the design of compliance and overload protection devices that mitigate the risk of periprosthetic fracture. We collected marker-based upper extremity kinematic data from non-amputee volunteers during advanced activities of daily living (AADLs) that applied dynamic loading to the humerus. Inverse dynamic analysis was applied to calculate the axial force, bending and torsional moments at three virtual amputation levels representing 25, 50, and 75% residual humeral length. The influences of amputation level, elbow flexion constraint, gender and anthropometric scaling were assessed. Results indicate that the proximal (25%) amputation level experienced significantly higher axial forces and bending moments across all subjects when compared to distal amputation levels (p?0.030). Constraining elbow flexion had a limited influence on peak transhumeral loads. Male subjects experienced higher axial forces during all evaluated activities (p?0.023). Peak axial force for all activities occurred during jumping jacks (174.5N). Peak bending (57.6Nm) and torsional (57.2Nm) moments occurred during jumping jacks and rapid internal humeral rotation, respectively. Calculated loads fall within the range of implant fixation failure loads reported in cadaveric investigations of humeral stem fixation; indicating that periprosthetic fracture may occur during non-contact AADLs. These kinematic data, collected over a range of AADLs, will aid in the development of overload protection devices and appropriate post-operative rehabilitation protocols that balance return to an active lifestyle with patient safety.

Project description:BackgroundActivity limitations of the upper extremity are a common finding for individuals living with stroke. Mental practice (MP) is a training method that uses cognitive rehearsal of activities to improve performance of those activities.ObjectivesTo determine if MP improves the outcome of upper extremity rehabilitation for individuals living with the effects of stroke.Search strategyWe searched the Cochrane Stroke Group Trials Register (November 2010), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, November 2009), PubMed (1965 to November 2009), EMBASE (1980 to November 2009), CINAHL (1982 to November 2009), PsycINFO (1872 to November 2009), Scopus (1996 to November 2009), Web of Science (1955 to November 2009), the Physiotherapy Evidence Database (PEDro), CIRRIE, REHABDATA, ongoing trials registers, and also handsearched relevant journals and searched reference lists.Selection criteriaRandomised controlled trials involving adults with stroke who had deficits in upper extremity function.Data collection and analysisTwo review authors independently selected trials for inclusion. We considered the primary outcome to be the ability of the arm to be used for appropriate tasks (i.e. arm function).Main resultsWe included six studies involving 119 participants. We combined studies that evaluated MP in addition to another treatment versus the other treatment alone. Mental practice in combination with other treatment appears more effective in improving upper extremity function than the other treatment alone (Z = 3.48, P = 0.0005; standardised mean difference (SMD) 1.37; 95% confidence interval (CI) 0.60 to 2.15). We attempted subgroup analyses, based on time since stroke and dosage of MP; however, numbers in each group were small. We evaluated the quality of the evidence with the PEDro scale, ranging from 6 to 9 out of 10; we determined the GRADE score to be moderate.Authors' conclusionsThere is limited evidence to suggest that MP in combination with other rehabilitation treatment appears to be beneficial in improving upper extremity function after stroke, as compared with other rehabilitation treatment without MP. Evidence regarding improvement in motor recovery and quality of movement is less clear. There is no clear pattern regarding the ideal dosage of MP required to improve outcomes. Further studies are required to evaluate the effect of MP on time post stroke, volume of MP that is required to affect the outcomes and whether improvement is maintained long-term. Numerous large ongoing studies will soon improve the evidence base.

Dataset Information

Proprioception deficits in chronic stroke-Upper extremity function and daily living.

Publications

Proprioception deficits in chronic stroke-Upper extremity function and daily living.

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