The hemiplegic arm after stroke: measurement and recovery.
Seven clinical tests have been used to study the recovery of arm function in 92 patients over 2 years following their stroke. These tests are simple and quick, and can be used by any interested observer. They form a hierarchical scale that measures recovery. Statistically significant improvement is only seen in the first 3 months. Fifty-six patients initially had non-functional arms; eight made a "complete recovery" and 14 a partial recovery. The tests described are inadequate on their own because they are not sufficiently sensitive at the upper range of ability. While recovery of lost function does relate to the degree of initial neurological loss in the arm, it seems to be largely independent of the overall severity of the stroke.
This article has been cited by other articles:
-
Hughes, A.M., Freeman, C.T., Burridge, J.H., Chappell, P.H., Lewin, P.L., Rogers, E.
(2009). Feasibility of Iterative Learning Control Mediated by Functional Electrical Stimulation for Reaching After Stroke. Neurorehabil Neural Repair
23: 559-568
[Abstract] -
Siengsukon, C., Boyd, L. A.
(2009). Sleep Enhances Off-line Spatial and Temporal Motor Learning After Stroke. Neurorehabil Neural Repair
23: 327-335
[Abstract] -
Beebe, J. A., Lang, C. E.
(2009). Active Range of Motion Predicts Upper Extremity Function 3 Months After Stroke. Stroke
40: 1772-1779
[Abstract] [Full Text] -
Siengsukon, C. F, Boyd, L. A
(2009). Does Sleep Promote Motor Learning? Implications for Physical Rehabilitation. ptjournal
89: 370-383
[Abstract] [Full Text] -
Carlsen, A. N., Chua, R., Inglis, J. T., Sanderson, D. J., Franks, I. M.
(2009). Differential Effects of Startle on Reaction Time for Finger and Arm Movements. J. Neurophysiol.
101: 306-314
[Abstract] [Full Text] -
Huijgen, B. C., Vollenbroek-Hutten, M. M., Zampolini, M., Opisso, E., Bernabeu, M., Van Nieuwenhoven, J., Ilsbroukx, S., Magni, R., Giacomozzi, C., Marcellari, V., Marchese, S. S., Hermens, H. J
(2008). Feasibility of a home-based telerehabilitation system compared to usual care: arm/hand function in patients with stroke, traumatic brain injury and multiple sclerosis. J Telemed Telecare
14: 249-256
[Abstract] [Full Text] -
Murata, Y., Higo, N., Oishi, T., Yamashita, A., Matsuda, K., Hayashi, M., Yamane, S.
(2008). Effects of Motor Training on the Recovery of Manual Dexterity After Primary Motor Cortex Lesion in Macaque Monkeys. J. Neurophysiol.
99: 773-786
[Abstract] [Full Text] -
Prabhakaran, S., Zarahn, E., Riley, C., Speizer, A., Chong, J. Y., Lazar, R. M., Marshall, R. S., Krakauer, J. W.
(2008). Inter-individual Variability in the Capacity for Motor Recovery After Ischemic Stroke. Neurorehabil Neural Repair
22: 64-71
[Abstract] -
Wolf, S. L
(2007). Revisiting Constraint-Induced Movement Therapy: Are We Too Smitten With the Mitten? Is All Nonuse "Learned"? and Other Quandaries. ptjournal
87: 1212-1223
[Abstract] [Full Text] -
Schaefer, S. Y., Haaland, K. Y., Sainburg, R. L.
(2007). Ipsilesional motor deficits following stroke reflect hemispheric specializations for movement control. Brain
130: 2146-2158
[Abstract] [Full Text] -
Hatakenaka, M., Miyai, I., Sakoda, S., Yanagihara, T.
(2007). Proximal paresis of the upper extremity in patients with stroke. Neurology
69: 348-355
[Abstract] [Full Text] -
Wagner, J. M, Lang, C. E, Sahrmann, S. A, Edwards, D. F, Dromerick, A. W
(2007). Sensorimotor Impairments and Reaching Performance in Subjects With Poststroke Hemiparesis During the First Few Months of Recovery. ptjournal
87: 751-765
[Abstract] [Full Text] -
Lang, C. E., Beebe, J. A.
(2007). Relating Movement Control at 9 Upper Extremity Segments to Loss of Hand Function in People with Chronic Hemiparesis. Neurorehabil Neural Repair
21: 279-291
[Abstract] -
Wagner, J. M., Lang, C. E., Sahrmann, S. A., Hu, Q., Bastian, A. J., Edwards, D. F., Dromerick, A. W.
(2006). Relationships between Sensorimotor Impairments and Reaching Deficits in Acute Hemiparesis. Neurorehabil Neural Repair
20: 406-416
[Abstract] -
Merians, A. S., Poizner, H., Boian, R., Burdea, G., Adamovich, S.
(2006). Sensorimotor Training in a Virtual Reality Environment: Does It Improve Functional Recovery Poststroke?. Neurorehabil Neural Repair
20: 252-267
[Abstract] -
Brogardh, C., Sjolund, B. H
(2006). Constraint-induced movement therapy in patients with stroke: a pilot study on effects of small group training and of extended mitt use. Clin Rehabil
20: 218-227
[Abstract] -
Yozbatiran, N., Donmez, B., Kayak, N., Bozan, O.
(2006). Electrical stimulation of wrist and fingers for sensory and functional recovery in acute hemiplegia. Clin Rehabil
20: 4-11
[Abstract] -
Platz, T, Eickhof, C, van Kaick, S, Engel, U, Pinkowski, C, Kalok, S, Pause, M
(2005). Impairment-oriented training or Bobath therapy for severe arm paresis after stroke: a single-blind, multicentre randomized controlled trial. Clin Rehabil
19: 714-724
[Abstract] -
Desrosiers, J., Bourbonnais, D., Corriveau, H., Gosselin, S., Bravo, G.
(2005). Effectiveness of unilateral and symmetrical bilateral task training for arm during the subacute phase after stroke: a randomized controlled trial. Clin Rehabil
19: 581-593
[Abstract] -
Turton, A. J, Britton, E.
(2005). A pilot randomized controlled trial of a daily muscle stretch regime to prevent contractures in the arm after stroke. Clin Rehabil
19: 600-612
[Abstract] -
Jones, A, Tilling, K, Wilson-Barnett, J, Newham, D J, Wolfe, C D.
(2005). Effect of recommended positioning on stroke outcome at six months: a randomized controlled trial. Clin Rehabil
19: 138-145
[Abstract] -
Alberts, J. L., Butler, A. J., Wolf, S. L.
(2004). The Effects of Constraint-Induced Therapy on Precision Grip: A Preliminary Study. Neurorehabil Neural Repair
18: 250-258
[Abstract] -
Turton, A. J, Butler, S. R
(2004). A multiple case design experiment to investigate the performance and neural effects of a programme for training hand function after stroke. Clin Rehabil
18: 754-763
[Abstract] -
Meldrum, D., Pittock, S. J, Hardiman, O., Dhuill, C. N., O'Regan, M., Moroney, J. T
(2004). Recovery of the upper limb post ischaemic stroke and the predictive value of the Orpington Prognostic Score. Clin Rehabil
18: 694-702
[Abstract] -
Canning, C. G, Ada, L., Adams, R., O'Dwyer, N. J
(2004). Loss of strength contributes more to physical disability after stroke than loss of dexterity. Clin Rehabil
18: 300-308
[Abstract] -
Bovend'Eerdt, T J., Dawes, H, Johansen-Berg, H, Wade, D T
(2004). Evaluation of the Modifid Jebsen Test of Hand Function and the University of Maryland Arm Questionnaire for Stroke. Clin Rehabil
18: 195-202
[Abstract] -
Kwakkel, G., Kollen, B. J., van der Grond, J., Prevo, A. J.H.
(2003). Probability of Regaining Dexterity in the Flaccid Upper Limb: Impact of Severity of Paresis and Time Since Onset in Acute Stroke. Stroke
34: 2181-2186
[Abstract] [Full Text] -
Lang, C. E., Schieber, M. H.
(2003). Differential Impairment of Individuated Finger Movements in Humans After Damage to the Motor Cortex or the Corticospinal Tract. J. Neurophysiol.
90: 1160-1170
[Abstract] [Full Text] -
Merians, A. S, Jack, D., Boian, R., Tremaine, M., Burdea, G. C, Adamovich, S. V, Recce, M., Poizner, H.
(2002). Virtual Reality-Augmented Rehabilitation for Patients Following Stroke. ptjournal
82: 898-915
[Abstract] [Full Text] -
Lai, S.-M., Studenski, S., Duncan, P. W., Perera, S.
(2002). Persisting Consequences of Stroke Measured by the Stroke Impact Scale. Stroke
33: 1840-1844
[Abstract] [Full Text] -
Hendricks, H T, Ijzerman, M J, de Kroon, J R, in 't Groen, F A C G, Zilvold, G
(2001). Functional electrical stimulation by means of the 'Ness Handmaster Orthosis' in chronic stroke patients: an exploratory study. Clin Rehabil
15: 217-220
[Abstract] -
Kirker, S. G., Jenner, J. R, Simpson, D. S, Wing, A. M
(2000). Changing patterns of postural hip muscle activity during recovery from stroke. Clin Rehabil
14: 618-626
[Abstract] -
Feys, H., Van Hees, J., Bruyninckx, F., Mercelis, R., De Weerdt, W.
(2000). Value of somatosensory and motor evoked potentials in predicting arm recovery after a stroke. J. Neurol. Neurosurg. Psychiatry
68: 323-331
[Abstract] [Full Text] -
Duncan, P. W., Wallace, D., Lai, S. M., Johnson, D., Embretson, S., Laster, L. J.
(1999). The Stroke Impact Scale Version 2.0 : Evaluation of Reliability, Validity, and Sensitivity to Change. Stroke
30
: 2131k-2140
[Abstract] [Full Text] -
Rand, D., (Tamar) Weiss, P. L., Gottlieb, D.
(1999). Does Proprioceptive Loss Influence Recovery of the Upper Extremity After Stroke?. Neurorehabil Neural Repair
13: 15-21
[Abstract] -
Escudero, J. V., Sancho, J., Bautista, D., Escudero, M., Lopez-Trigo, J.
(1998). Prognostic Value of Motor Evoked Potential Obtained by Transcranial Magnetic Brain Stimulation in Motor Function Recovery in Patients With Acute Ischemic Stroke. Stroke
29: 1854-1859
[Abstract] [Full Text] -
Feys, H. M., De Weerdt, W. J., Selz, B. E., Cox Steck, G. A., Spichiger, R., Vereeck, L. E., Putman, K. D., Van Hoydonck, G. A.
(1998). Effect of a Therapeutic Intervention for the Hemiplegic Upper Limb in the Acute Phase After Stroke : A Single-Blind, Randomized, Controlled Multicenter Trial. Stroke
29: 785-792
[Abstract] [Full Text] -
Alexander, M.
(1997). A 36-Year-Old Woman Recuperating From a Stroke. JAMA
277: 1970-1976
[Abstract] -
Reiter, F., Danni, M., Ceravolo, M. G., Provinciali, L.
(1996). Disability Changes After Treatment of Upper Limb Spasticity with Botulinum Toxin. Neurorehabil Neural Repair
10: 47-52
[Abstract] -
Mudie, M. H., Matyas, T. A.
(1996). Upper Extremity Retraining Following Stroke: Effects of Bilateral Practice. Neurorehabil Neural Repair
10: 167-184
[Abstract] -
Goldstein, L. B., Matchar, D. B.
(1994). Clinical Assessment of Stroke. JAMA
271: 1114-1120
[Abstract] -
Good, D. C.
(1994). Treatment Strategies for Enhancing Motor Recovery in Stroke Rehabilitation. Neurorehabil Neural Repair
8: 177-186
[Abstract] -
Sunderland, A., Tinson, D., Bradley, E.
(1990). Arm activity i n everyday life after stroke: measu rement using modified automatic-wind wrist watches ('actometers'). Clin Rehabil
4: 19-25
[Abstract] -
McDowell, F. H.
(1990). Stroke Rehabilitation. Neurorehabil Neural Repair
4: 187-192
-
Reding, M. J., McDowell, F. H.
(1989). Focused Stroke Rehabilitation Programs Improve Outcome. Arch Neurol
46: 700-701
[Abstract] -
Lindmark, B.
(1988). The improvement of different motor functions after stroke. Clin Rehabil
2: 275-283
[Abstract]
Register for free content
The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.
Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.
