TY - JOUR
T1 - Profile of upper limb recovery and development of secondary impairments in patients after stroke with a disabled upper limb: an observational study.
AU - Ada, Louise
AU - PRESTON, Elisabeth
AU - LANGHAMMER, Birgitta
AU - Canning, Colleen
N1 - Funding Information:
This study was supported by the Sydney University Research Grants - Sesqui Research and Development Scheme, Sydney, Australia. We are grateful to the patients of the Canberra and Manly Hospitals in Australia and Bærum Hospital in Norway who participated in this study and the staff who recruited participants and acted as blind measurers.
Publisher Copyright:
© 2018, © 2018 Taylor & Francis.
PY - 2020/1/2
Y1 - 2020/1/2
N2 - Purpose: To investigate, in patients after stroke with a very weak upper limb, the profile of recovery for upper limb activity over the first 12 weeks, and whether early secondary impairments predict later upper limb activity. Method: Forty patients within 2 weeks of stroke with a very weak upper limb (<4/6 Item 6 of Motor Assessment Scale) were observed longitudinally. Upper limb activity (Items 6, 7, and 8 of Motor Assessment Scale), shoulder subluxation (vertical distance), shoulder pain (visual analogue scale), and upper limb range of motion were measured at 2, 6, and 12 weeks poststroke. Results: By Week 12, upper limb activity was 1.0/18 (IQR 3.0). Shoulder subluxation was 42 mm (SD 8), 7 mm > the intact side at 2 weeks. Pain at rest was 0.1/10 (IQR 1.1), and pain during movement was 2.6/10 (IQR 4.5). Passive shoulder external rotation was 23° (SD 34), 30% of the intact side at 2 weeks. Shoulder pain during movement at 2 weeks predicted shoulder pain during movement at 6 and 12 weeks after stroke (p = 0.05). Conclusion: Most patients with a disabled upper limb after stroke have little recovery of activity in the first 12 weeks. Shoulder pain on movement at 2 weeks should be flagged as a predictor of future pain.
AB - Purpose: To investigate, in patients after stroke with a very weak upper limb, the profile of recovery for upper limb activity over the first 12 weeks, and whether early secondary impairments predict later upper limb activity. Method: Forty patients within 2 weeks of stroke with a very weak upper limb (<4/6 Item 6 of Motor Assessment Scale) were observed longitudinally. Upper limb activity (Items 6, 7, and 8 of Motor Assessment Scale), shoulder subluxation (vertical distance), shoulder pain (visual analogue scale), and upper limb range of motion were measured at 2, 6, and 12 weeks poststroke. Results: By Week 12, upper limb activity was 1.0/18 (IQR 3.0). Shoulder subluxation was 42 mm (SD 8), 7 mm > the intact side at 2 weeks. Pain at rest was 0.1/10 (IQR 1.1), and pain during movement was 2.6/10 (IQR 4.5). Passive shoulder external rotation was 23° (SD 34), 30% of the intact side at 2 weeks. Shoulder pain during movement at 2 weeks predicted shoulder pain during movement at 6 and 12 weeks after stroke (p = 0.05). Conclusion: Most patients with a disabled upper limb after stroke have little recovery of activity in the first 12 weeks. Shoulder pain on movement at 2 weeks should be flagged as a predictor of future pain.
KW - contracture
KW - Glenohumeral subluxation
KW - shoulder pain
KW - stroke
KW - upper extremity
UR - http://www.scopus.com/inward/record.url?scp=85048356748&partnerID=8YFLogxK
UR - http://www.mendeley.com/research/profile-upper-limb-recovery-development-secondary-impairments-patients-after-stroke-disabled-upper-l
U2 - 10.1080/09593985.2018.1482584
DO - 10.1080/09593985.2018.1482584
M3 - Article
SN - 0959-3985
VL - 36
SP - 196
EP - 202
JO - Physiotherapy Theory and Practice
JF - Physiotherapy Theory and Practice
IS - 1
ER -