DOI QR코드

DOI QR Code

Predictive Analyses for Activities of the Upper Extremity and Daily Living based on Impairment of the Upper Extremity in People with Stroke - Preliminary Study using Clinical Scales -

뇌졸중 환자의 위팔 손상 수준에 따른 위팔 활동과 일상생활 활동의 예측도 분석 - 임상적 평가를 이용한 예비 연구 -

  • Jung, Young-Il (Department of Physical Therapy, Drim Sol Hospital) ;
  • Woo, Young-Keun (Department of Physical Therapy, College of Medical Sciences, Jeonju University)
  • Received : 2018.10.02
  • Accepted : 2018.10.18
  • Published : 2018.12.31

Abstract

Purpose: This study analyzes the predictive power of upper extremity activity and the activities of daily living in patients with stroke using an easy-to-use evaluation tool. Methods: The Fugl-Meyer assessment (FMA) of the upper extremity and action research arm test (ARAT) are performed, and the Korean modified Barthel index (K-MBI) is measured. The predictive power of the upper extremity activity level and the daily activity level are analyzed using regression analysis. The statistical significance level is 0.05. Results: The coefficient of determination, R2, for predicting the ARAT using FMA was high at 0.88, but the regression equation for predicting the K-MBI using the FMA and ARAT did not show a statistically significant difference. Conclusion: The assessment of the upper extremity should be performed at the activity level, as well as the impairment level. The assessment for predicting the activities of daily living should be carried out for each level of the international classification of functioning (ICF), disability, and health, which can be linked to daily life, in addition to the assessment of the upper arm. Future research should conduct more diverse analyses using the ICF assessment tools at various levels.

Keywords

Table 1. General characteristics of subjects

GOSOBJ_2018_v16n3_495_t0001.png 이미지

Table 2. The equations for FMA on the ARAT by single regression analysis

GOSOBJ_2018_v16n3_495_t0002.png 이미지

Table 3. The equations for FMA on the K-MBI by single regression analysis

GOSOBJ_2018_v16n3_495_t0003.png 이미지

Table 4. The equations for ARAT on the K-MBI by single regression analysis

GOSOBJ_2018_v16n3_495_t0004.png 이미지

Table 5. The equations for FMA and ARAT on the K-MBI by multiple regression analysis

GOSOBJ_2018_v16n3_495_t0005.png 이미지

Table 6. Output for multiple regression analyses for the prediction of the KMBI from the FMA and ARAT

GOSOBJ_2018_v16n3_495_t0006.png 이미지

References

  1. Adler S, Beckers D, Buck M. PNF in practice: an illustrated guide, 4th ed. Berlin. Springer-Verlag. 2014.
  2. Barak S, Duncan PW. Issues in selecting outcome measures to assess functional recovery after stroke. The Journal of the American Society for Experimental Neuro Therapeutics. 2006;3(4):505-524.
  3. Boult C, Brummel SK. Post-stroke rehabilitation guidelines. The clinical practice committee of the American geriatrics society. Journal of the American Geriatrics Society. 1997;45(7):881-883. https://doi.org/10.1111/j.1532-5415.1997.tb01519.x
  4. Cieza A. Ewert T, Berdirhan UT, et al. Development of ICF core sets for patients with chronic conditions. Journal of Rehabilitation Medicine. 2004;36(44):9-11. https://doi.org/10.1080/16501960410015353
  5. De Weerdt WJG, Harrison MA. Measuring recovery of arm-hand function in stroke patients: a comparison of the Brunstrom-Fugl-Meyer test and the action research arm test. Physiotherapy Canada. 1985;37(2):65-70. https://doi.org/10.3138/ptc.37.2.065
  6. Dijkerman HC, Ietswaart M, Johnston M, et al. Does motor imagery training improve hand function in chronic stroke patients? A pilot study. Clinical Rehabilitation. 2004;18(5):538-549. https://doi.org/10.1191/0269215504cr769oa
  7. Duncan PW, Propst M, Nelson SG. Reliability of the Fugl-Meyer assessment of sensorimotor recovery following cerebrovascular accident. Physical Therapy. 1983;63(10):1606-1610. https://doi.org/10.1093/ptj/63.10.1606
  8. Faria-Fortini I, Michaelsen SM, Cassiano JG, et al. Upper extremity function in stroke subjects: relationships between the international classification of functioning, disability, and health domains. Journal of Hand Therapy. 2011;24(3):257-264. https://doi.org/10.1016/j.jht.2011.01.002
  9. Fong, KN, Chan CC, Au DK. Relationship of motor and cognitive abilities to functional performance in stroke rehabilitation. Brain Injury. 2001;15(5):443-453. https://doi.org/10.1080/02699050118772
  10. Fougeyrollas P. Documenting environmental factors for preventing the handicap creation process: Quebec contributions relating to ICIDH and social participation of people with functional differences. Disability and Rehabilitation. 1995;17(3-4):145-198. https://doi.org/10.3109/09638289509166709
  11. Fugl-meyer AR, Jaasko L, Leyman I, et al. The post-stroke hemiplegic patient. 1. a method for evaluation of physical performance. Scandinavian Journal of Rehabilitation Medicine. 1975;7(1):13-31.
  12. Gracies J, Marosszeky J, Renton R. et al. Short-term effects of dynamic lycra splints on upper limb in hemiplegia patients. Archives Physical Medicine Rehabilitation. 2000;81(1):1547-1555. https://doi.org/10.1053/apmr.2000.16346
  13. Harris JE, Eng JJ. Paretic upper-limb strength best explains arm activity in people with stroke. Physical Therapy. 2007;87(1):88-97. https://doi.org/10.2522/ptj.20060065
  14. Harwood RH, Prince M, Mann A, et al. Associations between diagnoses, impairments, disability and handicap in a population of elderly people. International Journal of Epidemiology. 1998;27(2):261-269. https://doi.org/10.1093/ije/27.2.261
  15. Hawng SK. Comprehend WHO's new international classification of disability (ICF) and the need for a concept of functional disability. Labor Policy Research. 2004;4(2):127-148.
  16. Hsieh CL, Hsueh IP, Chiang FM, et al. Inter-rater reliability and validity of the action research arm test in stroke patients. Age Ageing. 1998;27(2):107-113. https://doi.org/10.1093/ageing/27.2.107
  17. Jorgensen HS, Nakayama H, Raaschou HO, et al. Outcome and time course of recovery in stroke. Part II: time course of recovery. The Copenhagen stroke study. Archives of Physical Medicine and Rehabilitation. 1995;76(5):406-412. https://doi.org/10.1016/S0003-9993(95)80568-0
  18. Jung JH, Jo YN, Che SY. The effect of task-oriented movement therapy on upper extremity, upper extremity function and activities of daily living for stroke patients. Rehabililtation International Korea. 2011;15(3):231-253.
  19. Jung HY, Park BK, Shin HS, et al. Development of the Korean version of modified Barthel index (K-MBI): multi-center study for subjects with stroke. Journal of Korean Academy of Rehabilitation Medicine. 2007;31(3):283-297.
  20. Lang CE, Wagner JM, Dromerick AW, et al. Measurement of upper-extremity function early after stroke: properties of the action research arm test. Archives of Physical Medicine and Rehabilitation. 2006;87(12):1605-1610. https://doi.org/10.1016/j.apmr.2006.09.003
  21. Luke C, Dodd KJ, Brock K. Outcomes of the Bobath concepton upperlimb recovery following stroke. Clinical Rehabilitation. 2004;18(8):888-898. https://doi.org/10.1191/0269215504cr793oa
  22. McDonnell M. Action research arm test. Australian Journal of Physiotherapy. 2008;54(3):220. https://doi.org/10.1016/S0004-9514(08)70034-5
  23. Page SJ, Sisto SA, Johnston MV, et al. Modified constraint-induced therapy after subacute stroke: a preliminary study. Nerourehabilitayion And Neural Repair. 2002;16(3):290-295. https://doi.org/10.1177/154596830201600307
  24. Park MJ, Kang JY. ICF core sets for measuring functional status of acute stroke patients. Journal of Muscle and Joint Health. 2012;19(2):107-119. https://doi.org/10.5953/JMJH.2012.19.2.107
  25. Rabadi MH, Rabadi FM. Comparison of the action research arm test and the Fugl-Meyer assessment as measures of upper-extremity motor weakness after stroke. Archives of Physical Medicine and Rehabilitation. 2006;87(7):962-966. https://doi.org/10.1016/j.apmr.2006.02.036
  26. Salter K, Jutai JW, Teasell R, et al. Issues for selection of outcome measures in stroke rehabilitation: ICF participation. Disability and Rehabilitation. 2005;27(9):507-535. https://doi.org/10.1080/0963828040008552
  27. Sanford J, Moreiand J, Swanson LR, et al. Reliability of the Fugl-Meyer assessment for testing motor performance in patients following stroke. Physical Therapy. 1993;7(7):447-454.
  28. Shah S, Cooper B. Commentary on a critical evaluation of the Barthel index. The British Journal of Occupational Therapy. 1993;56(2):70-72. https://doi.org/10.1177/030802269305600210
  29. Soberg HL, Finset A, Roise O, et al. Identification and comparison of rehabilitation goals after multiple injuries: an analysis of the patients', physiotherapists' and other allied professionals' reported goals. Journal of Rehabilitation Medicine. 2008;40(5):340-346. https://doi.org/10.2340/16501977-0174
  30. Twitchell TE. The restoration of motor function following hemipleiga in man. Brain. 1951;74(4):443-480. https://doi.org/10.1093/brain/74.4.443
  31. Ustun TB, Chatterji S, Bickenbach J, et al. The international classification of functioning, disability and health: a new tool for understanding disability and health. Disability and Rehabilitation. 2003;25(11-12):565 -636. https://doi.org/10.1080/0963828031000137063
  32. Whitall J, Waller SMC, Silver KH, et al. Repetitive bilateral arm training with rhythmic auditory cueing improves motor function in chronic hemiparetic stroke. Stroke. 2000;31(10):2390-2395. https://doi.org/10.1161/01.STR.31.10.2390
  33. Woo YG. Assessment of the influence of physical impairments on activities in persons with stroke. Physical Therapy Korea. 2011;18(4):11-18.
  34. Yates JS, Lai SM, Duncan PW, et al. Falls in communitydwelling stroke survivors: an accumulated impairments model. Journal Of Rehabilitation Research And Development. 2002;39(3):385-479.