Objectively measured arm use in daily life improves during the first 6 months poststroke: a longitudinal observational cohort study.
G R H Regterschot, J B J Bussmann, Malou H J Fanchamps and 3 others
PMID 33741017WHAT IT FOUND
Affected arm use in daily life improved significantly during the first 12 weeks poststroke and gains were largely retained through 6 months.
Patients with excellent arm function recovery showed higher daily arm use and ratios than those with poor or moderate recovery.
Key findings
01Total daily use of the affected arm increased from week 3 to week 12, and the daily ratio between arms increased from week 3 to both week 12 and week 26.
02Patients in the excellent arm recovery cluster had significantly higher total daily use of the affected arm and daily arm use ratio compared to those in the poor/moderate cluster across all time points.
03The median daily ratio between arms in the excellent recovery cluster improved from 0.43 at week 3 to 0.73 at week 26, approaching values seen in healthy adults.
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
Small sample size (n=33) and single recruitment site limit generalizability. Only 18 participants had complete data for all three time points; the remaining 15 had missing data for at least one week. The study could not distinguish between arm use during therapy sessions and arm use in daily life outside of therapy. The sensor-based method measured movement counts rather than precise duration of arm use hours, limiting direct comparison with studies that measured time-based arm use. The small size of the recovery clusters may have prevented the detection of significant differences in the rate of change between groups.
Declared interests
The study was funded by ZonMw. No other conflicts of interest were declared.
The easy way to misread this
Do not assume that all stroke patients will experience similar improvements in daily arm use. Patients with poor or moderate arm function recovery showed significantly lower levels of affected arm use compared to those with excellent recovery, and the study did not prove that standard care alone will increase daily arm use in the poor/moderate group to the same extent.