學院

醫學院

系所

職能治療學系

題名

Proximal Fugl-Meyer Assessment scores predict clinically important upper limb improvement after three stroke rehabilitative interventions

作者

Lee, Y-Y., Hsieh, Y-W., Wu, C-Y., Lin, K-C.*, & Chen, C-K.

期刊名稱

Archives of Physical Medicine and Rehabilitation

發表日期

2015

著作性質

原著

語文

英文

關鍵字

Stroke, Rehabilitation, Predictors, Responders, Fugl-Meyer Assessment

摘要

Background: Determining appropriate rehabilitation approaches for individuals after stroke has been a challenge for clinicians.

Objective: This study aimed to identify the baseline motor characteristics of the patients who responded to 3 prominent intervention programs.

Design: A secondary analysis from clinical trials was conducted.

Methods: The study analyzed 174 individuals with chronic stroke who received interventions based on constraint-induced movement therapy (CIMT), robot-assisted therapy (RT), or mirror therapy (MT). The primary outcome measure was the change score of the upper-extremity Fugl-Meyer Assessment (UE-FMA). The potential predicting variables were baseline proximal, distal, and total UE-FMA, and Action Research Arm Test (ARAT) scores. We combined polynomial regression analyses and the minimal clinically important difference to stratify the patients as responders and non-responders for each intervention approach. 

Results: The baseline proximal UE-FMA significantly predicted clinically important improvement on the primary outcome after all 3 interventions. Participants with baseline proximal UE-FMA scores approximately <30 benefited significantly from CIMT and RT, whereas participants with scores between 21 and 35 demonstrated significant improvements after MT. Baseline distal and total UE-FMA and ARAT scores could also predict upper limb improvements after CIMT and MT but not after RT.

Limitations: Participants with very low or high baseline UE-FMA scores were not recruited, which may limit interpretations of the results. Generality of the current findings needs further validation.

Conclusion: This study could inform clinicians about the selection of suitable rehabilitation approaches to help patients achieve clinically meaningful improvements in upper extremity function.