• Physical Therapy Korea
• /
• v.26 no.2
• /
• pp.24-33
• /
• 2019

Background: Spontaneous use of the upper extremities on the affected side of patients with stroke is a meaningful indicator of recovery and may vary by the age or dominant hand of patients. No prior study has reported changes in actual amount of use test (AAUT) and motor activity log (MAL)-28 according to age and handedness in healthy adults, and AAUT inter-rater reliability for assessment of healthy adults. Objects: This study aimed to (1) research the differences in AAUT and MAL-28 according to age and handedness in healthy adults, and (2) determine the inter-rater reliability of the AAUT. Methods: Seventy healthy adults participated in this study. The MAL-28 was assessed by dividing 61 subjects into young right-handed ($n_1=20$), young left-handed ($n_2=21$), and older right-handed ($n_3=20$) groups. The AAUT was assessed by dividing 63 subjects into young right-handed ($n_1=25$), young left-handed ($n_2=18$), and older right-handed ($n_3=20$) groups. Student's t-test and the Wilcoxon signedrank test were used for statistical analysis. Results: The Amount of Use (AOU) scale values for each group showed no significant differences between age groups and handedness groups in the MAL-28 (p>.05). The AAUT AOU scale value showed significant differences regarding dominant handedness in the AAUT (p<.05), but no significant differences according to age (p>.05). (2) Inter-rater reliability of the AAUT was excellent, except few items (item 9, 11, and 12). Conclusion: Although both the MAL-28 and the AAUT measured how much participants used their dominant arms in healthy subjects, the AAUT only showed significantly higher dominant arm use in left hander than the right hander. In addition, the inter-rater reliability of the AAUT was excellent. Current results can be utilized as a basic information when clinicians develop rehabilitation strategies, and AAUT was shown to be a reliable evaluation tool for measurement of upper extremity use in Korean adults, based on the reliability demonstrated by this study.

• PNF and Movement
• /
• v.18 no.1
• /
• pp.23-34
• /
• 2020

Purpose: To explore the effects of action observation combined with modified constraint-induced movement therapy on upper-extremity function and the activities of daily living in subacute stroke patients. Methods: Twenty-four subacute stroke patients were randomly assigned to the experimental group or the control group (n = 12 each). Both groups received therapy based on motor learning concepts, including repetitive and task-specific practice. The experimental group watched video clips for 10 minutes related to tasks performed during modified constraint-induced movement therapy while the control group watched videos unrelated to upper-extremity movement. These programs were performed for 40 minutes a day five times a week for four weeks. Their scores on the Fugl-Meyer assessment of upper extremities (FMA-UE), the action research arm test (ARAT), a motor activity log (amount of use [AOU] and quality of movement [QOM]), and the modified Barthel index (MBI) were recorded. Results: In both groups, all variables were significantly different between the pre-test and post-test periods (p < 0.05). The post-test variables were significantly different within each group (p < 0.05). In the experimental group, the changes between pre-test and post-test scores in the FMA-UE (14.39 ± 4.31 versus 6.31 ± 4.63), the ARAT (16.00 ± 4.73 versus 11.46 ± 3.73), MAL-AOU (1.57 ± 0.15 versus 1.18 ± 0.28), and MBI (27.54 ± 4.65 versus 18.08 ± 8.52) were significantly higher than those of the control group (p < 0.05). Conclusion: These findings suggest that action observation combined with modified constraint-induced movement therapy may be a beneficial rehabilitation option to improve upper-extremity function in subacute stroke patients with moderate impairment.