學院

醫學院

系所

職能治療學系

題名

Kinematic measures of arm-trunk movements during unilateral and bilateral reaching predict clinically important change in perceived arm use in daily activities after intensive stroke rehabilitation

作者

Chen, H-L., Lin, K-C., Liing, R-J., Wu, C-Y.^*, & Chen-C-L.

期刊名稱

Journal of NeuroEngineering and Rehabilitation（SCI-Indexed）

發表日期

2015

著作性質

原著

語文

英文

關鍵字

kinematics, reaching, stroke, clinically important change, daily function

摘要

Background. Kinematic analysis has been used to objectively evaluate movement patterns, quality, and strategies during reaching tasks. However, no study has investigated whether kinematic variables during unilateral and bilateral reaching tasks predict a patient’s perceived arm use in daily activities after an intensive intervention. Therefore, this study investigated whether kinematic measures during unilateral and bilateral reaching tasks before an intervention can predict clinically meaningful improvement in perceived arm use in daily activities after intensive poststroke rehabilitation.

Methods. The study was a secondary analysis of 120 subjects with chronic stroke who received 90 to 120 minutes of intensive intervention every weekday for 3 to 4 weeks. Reaching kinematics during unilateral and bilateral tasks and the Motor Activity Log (MAL) were evaluated before and after the intervention.

Results. Kinematic variables explained 22% and 11% variance in actual amount of use (AOU) and quality of movement (QOM) of MAL improvement during unilateral reaching tasks and 21% and 31% in MAL-AOU and MAL-QOM during bilateral reaching tasks. Selected kinematic variables, including endpoint variables, trunk involvement, and joint recruitment and interjoint coordination, were significant predictors for improvement in perceived arm use in daily activities (P < 0.05).

Conclusions. Arm-trunk kinematics may be used to predict clinically meaningful improvement in perceived arm use in daily activities after intensive rehabilitation. Involvement of interjoint coordination and trunk control variables as predictors in bilateral reaching models indicates that a high level of motor control (i.e., multijoint coordination) and trunk stability may be important in obtaining treatment gains in arm use, especially for bilateral daily activities, in intensive rehabilitation after stroke.