What is the longitudinal profile of impairments and can we predict difficulty caring for the profoundly-affected arm in the first year post-stroke?
OBJECTIVE: To establish the longitudinal profile of impairments of body functions and activity limitations of the arm, and evaluate potential predictors of difficulty caring for the profoundly-affected arm post-stroke. DESIGN: Prospective cohort study. SETTING: Three UK stroke services. PARTICIPANTS: People unlikely to regain functional use of the arm (N=155) were recruited at 2-4 weeks post-stroke, and followed up at 3, 6 and 12 months. Potential predictors at baseline were hypertonicity, pain, motor control, mood, sensation/perception, age and stroke severity. INTERVENTIONS: NA MAIN OUTCOME MEASURES: Difficulty caring for the arm (LASIS), pain, hypertonicity, range of movement, arm function and skin integrity. Multi-variable linear regression identified the best fitting model for predicting LASIS at 12 months. RESULTS: One hundred and ten participants (71%) were reviewed at one year. There was a large variation in the profile of arm functions and activity limitations. Inability or severe difficulty caring for the arm affected 29% of participants. Hypertonicity developed in 77%, with severe hypertonicity present in 25%. Pain was reported by 65%, 94% developed shoulder contracture and 6% had macerated skin. Difficulty caring for the arm increased with age, greater level of hypertonicity and stroke classification; collectively these factors accounted for 33% of the variance in LASIS. CONCLUSIONS: At one year post-stroke, there was a high incidence of impairments of body functions and activity limitations in people with a profoundly-affected arm. Individual profiles were very variable and although some pre-disposing factors have been identified, it remains difficult to predict who is at greatest risk.
|dc.title||What is the longitudinal profile of impairments and can we predict difficulty caring for the profoundly-affected arm in the first year post-stroke?||en|
|plymouth.journal||Arch Phys Med Rehabil||en|
|plymouth.organisational-group||/Plymouth/00 Groups by role|
|plymouth.organisational-group||/Plymouth/00 Groups by role/Academics|
|plymouth.organisational-group||/Plymouth/00 Groups by role/Post-Graduate Research Students|
|plymouth.organisational-group||/Plymouth/Faculty of Health: Medicine, Dentistry and Human Sciences|
|plymouth.organisational-group||/Plymouth/Faculty of Health: Medicine, Dentistry and Human Sciences/Peninsula Medical School|
|plymouth.organisational-group||/Plymouth/Faculty of Health: Medicine, Dentistry and Human Sciences/School of Health Professions|
|plymouth.organisational-group||/Plymouth/REF 2021 Researchers by UoA|
|plymouth.organisational-group||/Plymouth/REF 2021 Researchers by UoA/UoA03 Allied Health Professions, Dentistry, Nursing and Pharmacy|
|plymouth.organisational-group||/Plymouth/Research Groups/Institute of Health and Community|
|plymouth.organisational-group||/Plymouth/Research Groups/Institute of Translational and Stratified Medicine (ITSMED)|
|plymouth.organisational-group||/Plymouth/Research Groups/Institute of Translational and Stratified Medicine (ITSMED)/CBBB|