| dc.description.abstract | Background and purpose: Upper limb recovery following stroke is a complex process, dependent on the integrity of the involved neural systems. The Action Research Arm Test (ARAT) assess proximal and distal motor control through subscales with different requirements. The purpose of the study was to investigate recovery measured withe the ARAT, explore how demographic and clinical factors were associated with recovery and explore these variables in participants who experienced a clinically meaningful change.
Methods: During inpatient rehabilitation following stroke, the upper limb function of the 24 recruited participants was assessed on admission, discharge and weekly with the ARAT. The participants received usual care physiotherapy daily during their stay. Progress of the subscales and Total score was investigated, associations between demographic and clinical variables and recovery explored, and the group of participants who experienced a clinically meaningful change was compared to those who did not.
Results: All subscales and Total ARAT scores showed significant improvements from admission to discharge, and significant weekly progress from admission to week 3. The Pinch subscale had consistently lower scores and Gross movement higher scores than the other subscales. Participants with a right-side hemiparesis showed a significantly larger improvement on the Grip, Pinch and Total score. All participants who experienced a clinically meaningful change had a right-side hemiparesis, but there were no significant differences between the groups.
Conclusions: The participants showed significant changes on the ARAT subscales and Total score during subacute rehabilitation after stroke. Nine participants showed a clinically meaningful change but were not significantly different from the other participants. Affected side was associated with improvement. Varying requirements and degree of proximal and distal control necessary to complete items indicate the need to report subscale scores as well as Total score to provide a better image of recovery and guide decision making. | |