Changes in Upper-Extremity Functional Capacity and Daily Performance During Outpatient Occupational Therapy for People With Stroke

Author:

Doman Caitlin A.1,Waddell Kimberly J.2,Bailey Ryan R.3,Moore Jennifer L.4,Lang Catherine E.5

Affiliation:

1. Caitlin A. Doman, MS, OTR/L, is Occupational Therapist, Rehabilitation Institute of Chicago, Chicago, IL

2. Kimberly J. Waddell, MS, OTR/L, is Graduate Student, Movement Science and Program in Physical Therapy, Washington University School of Medicine, St. Louis, MO

3. Ryan R. Bailey, MSOT, MSCI, PhD, was Graduate Student, Movement Science Program and Program in Physical Therapy, Washington University School of Medicine, St. Louis, MO, at the time of the study

4. Jennifer L. Moore, PT, DHS, NCS, is Physical Therapist, Rehabilitation Institute of Chicago, Chicago, IL

5. Catherine E. Lang, PT, PhD, is Professor, Program in Physical Therapy, Program in Occupational Therapy, and Department of Neurology, Washington University School of Medicine, St. Louis, MO; langc@wustl.edu

Abstract

Abstract OBJECTIVE. This study explored how upper-extremity (UE) functional capacity and daily performance change during the course of outpatient rehabilitation in people with stroke. METHOD. Fifteen participants receiving outpatient occupational therapy services for UE paresis poststroke were enrolled. UE motor capacity was measured with the Action Research Arm Test (ARAT), and UE performance was measured using bilateral, wrist-worn accelerometers. Measurements were taken at or near the start of therapy, at every 10th visit or every 30 days throughout the duration of services, and at discharge. RESULTS. Three patterns were observed: (1) increase in ARAT scores and more normalized accelerometry profiles, (2) increase in ARAT scores but no change in accelerometry profiles, and (3) no change in ARAT scores or in accelerometry profiles. CONCLUSION. UE performance in daily life was highly variable, with inconsistencies between change in UE capacity and change in UE performance. UE capacity and performance are important constructs to assess separately during rehabilitation.

Publisher

AOTA Press

Subject

Occupational Therapy

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