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. 2017 Jun 14;12(6):e0179453.
doi: 10.1371/journal.pone.0179453. eCollection 2017.

Changes in arm-hand function and arm-hand skill performance in patients after stroke during and after rehabilitation

Johan Anton Franck  1   2 , Rob Johannes Elise Marie Smeets  3 , Henk Alexander Maria Seelen  2   3
Affiliations

Changes in arm-hand function and arm-hand skill performance in patients after stroke during and after rehabilitation

Johan Anton Franck et al. PLoS One. .

Abstract

Background: Arm-hand rehabilitation programs applied in stroke rehabilitation frequently target specific populations and thus are less applicable in heterogeneous patient populations. Besides, changes in arm-hand function (AHF) and arm-hand skill performance (AHSP) during and after a specific and well-described rehabilitation treatment are often not well evaluated.

Method: This single-armed prospective cohort study featured three subgroups of stroke patients with either a severely, moderately or mildly impaired AHF. Rehabilitation treatment consisted of a Concise_Arm_and_hand_ Rehabilitation_Approach_in_Stroke (CARAS). Measurements at function and activity level were performed at admission, clinical discharge, 3, 6, 9 and 12 months after clinical discharge.

Results: Eighty-nine stroke patients (M/F:63/23; mean age:57.6yr (+/-10.6); post-stroke time:29.8 days (+/-20.1)) participated. All patients improved on AHF and arm-hand capacity during and after rehabilitation, except on grip strength in the severely affected subgroup. Largest gains occurred in patients with a moderately affected AHF. As to self-perceived AHSP, on average, all subgroups improved over time. A small percentage of patients declined regarding self-perceived AHSP post-rehabilitation.

Conclusions: A majority of stroke patients across the whole arm-hand impairment severity spectrum significantly improved on AHF, arm-hand capacity and self-perceived AHSP. These were maintained up to one year post-rehabilitation. Results may serve as a control condition in future studies.

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Conflict of interest statement

Competing Interests: We have the following interests: Johan A. Franck, Rob J.E.M. Smeets and Henk A.M. Seelen are employed by Adelante. There are no patents, products in development or marketed products to declare. This does not alter our adherence to all the PLOS ONE policies on sharing data and materials, as detailed online in the guide for authors.

Figures

Fig 1
Fig 1. Overview of measurement timing.
T = time; BL = baseline; CD = clinical discharge; m = month.
Fig 2
Fig 2. Boxplots of the FM data per measurement moment for each of the three groups.
FM = Fugl Meyer Motor Assessment; TBL = Baseline; TCD = clinical discharge; T3m = (= TCD + 3 months); T6m (= TCD + 6 months); T9m (= TCD + 9 months);T12m (= TCD + 12 months). Circle = outlier value; Asterisk = far out value.
Fig 3
Fig 3. Boxplots of the grip strength data per measurement moment for each of the three groups.
TBL = Baseline; TCD = Clinical Discharge; T3m = (= TCD + 3 months); T6m (= TCD + 6 months); T9m (= TCD + 9 months);T12m (= TCD + 12 months). Circles = outlier value; Asterisk = far out value.
Fig 4
Fig 4. Boxplots of the ARAT data per measurement moment for each of the three groups.
ARAT = Action Research Arm Test; TBL = Baseline; TCD = Clinical Discharge; T3m = (= TCD + 3 months); T6m (= TCD + 6 months); T9m (= TCD + 9 months);T12m (= TCD + 12 months). Circles = outlier value; Asterisk = far out value.
Fig 5
Fig 5. Boxplots of the ABILHAND results per measurement moment for each of the three groups.
TBL = Baseline; TCD = Clinical Discharge; T3m = (= TCD + 3 months); T6m (= TCD + 6 months); T9m (= TCD + 9 months);T12m (= TCD + 12 months). Circles = outlier value; Asterisk = far out value.
See this image and copyright information in PMC

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