Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Jan;26(1):76-84.
doi: 10.1177/1545968311408918. Epub 2011 Jun 21.

Disparity between functional recovery and daily use of the upper and lower extremities during subacute stroke rehabilitation

Debbie Rand  1 , Janice J Eng
Affiliations

Disparity between functional recovery and daily use of the upper and lower extremities during subacute stroke rehabilitation

Debbie Rand et al. Neurorehabil Neural Repair. 2012 Jan.

Abstract

Background: Although inpatient rehabilitation may enhance an individual's functional ability after stroke, it is not known whether these improvements are accompanied by an increase in daily use of the arms and legs.

Objectives: To determine the change in daily use of the upper and lower extremities of stroke patients during rehabilitation and to compare these values with that of community-dwelling older adults.

Methods: A total of 60 stroke patients underwent functional assessments and also wore 3 accelerometers for 3 consecutive weekdays on admission to rehabilitation and 3 weeks later prior to hospital discharge. The number of steps and upper-extremity activity counts were measured over the waking hours and during daily use for occupational therapy (OT) and physical therapy (PT) sessions. Healthy older adults (n = 40) also wore 3 accelerometers for 5 consecutive days.

Results: Stroke patients demonstrated a significant increase in mobility function, and this was accompanied by an increase in daily walking over the entire day as well as in PT. However, increases in daily walking were found predominantly in patients who were wheelchair users (and not walkers) at the time of admission. Control walking values (5202 steps) were more than 17 times that of stroke patients. Despite significant improvements in paretic hand function, no increase in daily use of the paretic or nonparetic hand was found over the entire day or in PT.

Conclusions: A disparity between functional recovery and increases in daily use of the upper and lower extremities was found during inpatient stroke rehabilitation.

PubMed Disclaimer

Conflict of interest statement

Declaration of Conflicting Interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1
Figure 1
Data collection of the in-patient sample during stroke rehabilitation
Figure 2
Figure 2
CONSORT flow diagram of recruitment to the study
See this image and copyright information in PMC

References

    1. Teasell R, Bayona N, Heitzner J. The Evidence-Based Review of Stroke Rehabilitation (EBRSR) reviews current practices in stroke rehabilitation 2008. Clinical Consequences of Stroke. Downloaded on July 22nd 2010 from URL: http://www.ebrsr.com/uploads/Module_2_clinical_consequences_final.pdf.
    1. Nudo RJ, Wise BM, SiFuentes F, Milliken GW. Neural substrates for the effects of rehabilitative training on motor recovery after ischemic infarct. Science. 1996;272:1791–1794. - PubMed
    1. Boyd L, Winstein C. Explicit information interferes with implicit motor learning of both continuous and discrete movement tasks after stroke. J Neurol Phys Ther. 2006;30:46–57. - PubMed
    1. Lang CE, MacDonald JR, Reisman DS, et al. Observation of amounts of movement practice provided during stroke rehabilitation. Arch Phys Med Rehabil. 2009;90:1692–1698. - PMC - PubMed
    1. Bernhardt J, Dewey H, Thrift A, Donnan G. Inactive and alone; physical activity within the first 14 days of acute stroke unit care. Stroke. 2004;35:1005–1009. - PubMed

Publication types

Grants and funding