Beyond Arm Capacity in Chronic Stroke: Evaluating Paretic Arm Non-Use Through Arm Efficiency-A Cross-Sectional Study.
Gaël Le Perf, Germain Faity, Denis Mottet and 3 others
PMID 39995065WHAT IT FOUND
In 30 adults after stroke, home use of the paretic arm matched a model based on arm efficiency better than a model based on arm capacity.
A paretic-to-non-paretic Box and Block ratio predicted real-life arm use better than Fugl-Meyer or Wolf Motor Function Test.
Key findings
01The arm efficiency model fit the home arm-use data better than the arm capacity model.
02The paretic/non-paretic Box and Block ratio was the only clinical measure retained in the model explaining home arm use.
03Using the efficiency model, 13 participants were classified as non-users, while the capacity model classified 26 participants.
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 was a convenience sample of 30 participants, and no subgroup analyses were conducted because of the small sample. The models ignored bimanual movements, which accounted for at least 8% of ADLs in the accelerometer data. The accelerometer method had not been validated against real-world conditions. Participants had mild arm motor impairment, so results may not apply to more severe weakness. The Box and Block test does not assess fine dexterity or tasks where the paretic hand stabilizes an object. Non-use status was not checked with a validated tool such as the Bilateral Arm Reaching Test.
Declared interests
The authors declared no potential conflicts of interest. The clinical trial was funded by the Direction générale de l’offre de soins of the French Ministère des Affaires Sociales et de la Santé, with additional support from LabEx NUMEV within the I-Site MUSE.
The easy way to misread this
Do not read this as proof that arm efficiency causes non-use or that the model is ready to guide treatment decisions. The study is cross-sectional, used a convenience sample of 30 participants, and the accelerometer method was not validated against real-world conditions.