Autonomy support encourages use of more-affected arm post-stroke.
Sujin Kim, Yumi Shin, Yeonwoo Jeong and 2 others
PMID 37679781WHAT IT FOUND
Stroke survivors allowed to choose their own task difficulty during reaching training used their more-affected arm significantly more in the lab.
However, this did not transfer to real-world daily activities. High repetition alone improved motor performance, but only autonomy support changed spontaneous arm choice.
Key findings
01Participants in the autonomy support group significantly increased their use of the more-affected arm on the custom IMES test, while the control group did not.
02There was no significant difference between groups or change over time in the Actual Amount of Use Test, a clinical measure of real-world arm use.
03Both groups improved in motor performance and self-efficacy after training, but the autonomy support group was the only one to increase successful experiences during the training sessions.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The sample size was small, with only 12 participants in the control group and 14 in the autonomy support group. The training task was a simple reaching movement, which may not reflect the complex bimanual nature of real-world daily activities. The control group was subjected to random task difficulty levels, which may have artificially hindered their learning compared to a personalized training mode. The study did not include a follow-up period to see if the effects on arm use persisted after training ended.
Declared interests
The study was funded by the Translational Research Program for Rehabilitation Robots.
The easy way to misread this
Do not assume that allowing patients to choose task difficulty will improve their use of the affected arm in daily life. The study found a significant increase in arm use only on the custom lab-based test, while the clinical measure of real-world use showed no change.