Abstract
Haaland KY, Mutha PK, Rinehart JK, Daniels M, Cushnyr B, Adair JC. Relationship between
arm usage and instrumental activities of daily living after unilateral stroke.
Objective
To determine whether the preferred pattern of arm use after unilateral hemispheric
damage was associated with better everyday functioning. Our previous work showed that
right-handed stroke patients with right hemisphere damage (RHD) used their right,
ipsilesional arm most frequently, while those with left hemisphere damage (LHD) used
both arms together most frequently. This effect was explained by right-hand preference,
but its relationship to functional performance is not known.
Design
Observational cohort.
Setting
Research laboratory.
Participants
Stroke patients (n=60; 30 RHD, 30 LHD) and healthy controls (n=52).
Interventions
Not applicable.
Main Outcome Measures
The Functional Impact Assessment was used to assess performance on instrumental activities
of daily living (IADLs).
Results
The preferred patterns of arm use were similar to those in our previous report. However,
it was the greater use of both arms together that was associated with better IADL
performance in both stroke groups. Ipsilesional arm use alone was not significantly
associated with IADL performance in the RHD group and was associated with poorer performance
in the LHD group.
Conclusions
The modal arm use pattern did not always optimize IADL functioning. Better IADL functioning
in both stroke groups was associated with the use of both arms together, which is
the most common arm use pattern of healthy individuals doing these same IADLs. An
important practical question that arises from these findings is whether bilateral
arm rehabilitation should be emphasized, because using both arms together is the best
predictor of better performance on everyday tasks.
Key Words
List of Abbreviations:
ADL (activity of daily living), FIA (Functional Impact Assessment), IADL (instrumental activity of daily living), LHD (left hemisphere damage), RHD (right hemisphere damage)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: May 28, 2012
Footnotes
Supported by a Department of Veterans Affairs Rehabilitation Research and Development Merit Review (grant no. B4125R).
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 Jul 24, 2012, at www.archives-pmr.org.
Reprints are not available from the author.
Identification
Copyright
© 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
