Can stroke survivors with severe upper arm disability achieve a clinically important change in arm function during inpatient rehabilitation? A multicentre, prospective, observational study

Hayward, Kathryn S., Kuys, Suzanne S., Barker, Ruth N., and Brauer, Sandra G. (2014) Can stroke survivors with severe upper arm disability achieve a clinically important change in arm function during inpatient rehabilitation? A multicentre, prospective, observational study. NeuroRehabilitation, 35 (1). pp. 17-23.

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Abstract

BACKGROUND: Severe arm disability is considered to indicate poor potential to recover arm function.

OBJECTIVE: Determine if stroke survivors with severe upper arm disability can achieve a clinically important change in arm function on discharge from inpatient rehabilitation.

METHODS: 618 stroke survivors from 16 inpatient rehabilitation units were assessed on admission and discharge using the Motor Assessment Scale Item 6 Upper Arm Function (MAS6). Admission scores defined participants with severe (MAS6 <= 2) and mild/moderate (MAS6 >2) upper arm disability. A clinically important change was evaluated according to: 1) statistical significance; 2) minimal clinical importance difference (MCID); and 3) shift in disability status i.e., severe to mild/moderate. Achievers of a MCID and shift were compared to non-achievers.

RESULTS: Stroke survivors with severe upper arm disability (n = 226) demonstrated a significant improvement in arm function (p < 0.001) at discharge. A MCID was achieved by 68% (n = 155) and a shift from severe to mild/moderate upper arm disability on discharge by 45%(n = 102) of participants. Achievers had a significantly shorter interval from stroke onset to inpatient rehabilitation admission (p < 0.002).

CONCLUSION: Stroke survivors with severe upper arm disability can achieve a clinically important change during inpatient rehabilitation.

Item ID: 36104
Item Type: Article (Research - C1)
ISSN: 1878-6448
Keywords: stroke, inpatient rehabilitation, functional recovery, severe, motor
Date Deposited: 12 Nov 2014 12:20
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1109 Neurosciences > 110904 Neurology and Neuromuscular Diseases @ 50%
11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110317 Physiotherapy @ 50%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920111 Nervous System and Disorders @ 50%
92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920403 Disability and Functional Capacity @ 50%
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