Abstract
Michielsen ME, Selles RW, Stam HJ, Ribbers GM, Bussmann JB. Quantifying nonuse in
chronic stroke patients: a study into paretic, nonparetic, and bimanual upper-limb
use in daily life.
Objective
To quantify uni- and bimanual upper-limb use in patients with chronic stroke in daily
life compared with healthy controls.
Design
Cross-sectional observational study.
Setting
Outpatient rehabilitation center.
Participants
Patients with chronic stroke (n=38) and healthy controls (n=18).
Intervention
Not applicable.
Main Outcome Measures
Upper-limb use in daily life was measured with an accelerometry-based upper-limb activity
monitor, an accelerometer based measurement device. Unimanual use of the paretic and
the nonparetic side and bimanual upper-limb use were measured for a period of 24 hours.
Outcomes were expressed in terms of both duration and intensity.
Results
Patients used their unaffected limb much more than their affected limb (5.3h vs 2.4h),
while controls used both limbs a more equal amount of time (5.4h vs 5.1h). Patients
used their paretic side less than controls used their nondominant side and their nonparetic
side more than controls their dominant side. The intensity with which patients used
their paretic side was lower than that with which controls used their nondominant
side, while that of the nonparetic side was higher than that of the dominant side
of controls. Finally, patients used their paretic side almost exclusively in bimanual
activities. During bimanual activities, the intensity with which they used their affected
side was much lower than that of the nonaffected side.
Conclusion
Our data show considerable nonuse of the paretic side, both in duration and in intensity,
and both during unimanual and bimanual activities in patients with chronic stroke.
Patients do compensate for this with increased use of the nonparetic side.
Key Words
List of Abbreviations:
CIMT (constraint-induced movement therapy), MAL (Motor Activity Log), ULAM (Upper Limb-Activity Monitor)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: March 29, 2012
Footnotes
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
In-press corrected proof published online on May 22, 2012, at www.archives-pmr.org.
Identification
Copyright
© 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
