Upper Limb Performance in Daily Life Improves Over the First 12 Weeks Poststroke.
Kimberly J Waddell, Michael J Strube, Rachel G Tabak and 2 others
PMID 31431125WHAT IT FOUND
Upper limb use in daily life improved over the first 12 weeks post-stroke, especially in those with low initial capacity.
Belief, confidence, and motivation were already high and did not predict improvement. Early therapy may better target self-perceived barriers than psychosocial factors.
Key findings
01Sensor-measured upper limb performance in daily life significantly improved over the first 12 weeks post-stroke.
02Individual belief, confidence, and motivation did not significantly modify the rate of upper limb performance improvement over time.
03Participants with higher baseline upper limb capacity started with better daily performance but showed less improvement over time compared to those with lower baseline capacity.
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 (29 participants) from a single urban hospital limits generalizability. Participants were required to be expected to return to independent living, excluding those with more severe disability or complex social needs. Rehabilitation services were not controlled, so the amount and type of therapy varied by patient and could have influenced results. The survey used to measure belief, confidence, and motivation was not a validated, comprehensive tool for these complex constructs. The study only tracked patients for 12 weeks, so it does not show if these trends continue or reverse later.
Declared interests
The study was supported by the National Institutes of Health (N.I.H., Extramural). No other conflicts of interest were declared.
The easy way to misread this
Do not conclude that belief, confidence, and motivation are unimportant for stroke recovery in general. They simply did not predict daily upper limb use improvement in this specific early post-stroke window, likely because levels were already very high in this sample. These factors may become critical targets later in recovery.