Prediction of Paretic Upper Limb Motor Function with Self-perceived Performance in Upper Limb Movement

Research Objectives To determine whether self-perceived performance of upper limb movement makes an independent contribution and to quantify its relative contribution to the performance of functional activity of upper limb in patients with stroke. Design This is a cross-sectional design. Setting This study was held in the neurorehabilitation laboratory in the university. Participants Total 87 subjects (50 males, 37 females, mean age=61.12±6.88 years, time post-stroke=6.31±2.84 years) were recruited. Interventions No intervention Main Outcome Measures The paretic hand control was assessed by hand section in Fugl-Meyer Assessment (FMA-hand). The performance of functional activity of upper limb was assessed by Action Research Arm Test (ARAT). The self-perceived performance was assessed by Quality of Movement section in Motor Activity Log (MAL-QOM). The relative contributions of the independent variables in predicting the ARAT scores was determined by multiple linear regressions with the forced entry method. Results The mean ARAT score of 23.8±16.6. The mean FMA-hand score was 7.6±2.8. The mean MAL-QOM score was 39.4±37.8. After controlling for age, gender and body mass index, results of multiple linear regression analysis indicated that the FMA-hand score could independently predict 41.6% of the variance in the ARAT scores. The MAL-QOM score could predict an extra 16.9% variance in the ARAT scores after controlling the demographic information and the FMA-hand score. A total of 65.0% variance of the ARAT score was explained by the final regression model. Conclusions Self-perceived performance of upper limb motor function (MAL-QOM score) is a significant predictor of performance of functional activity of upper limb in patients with stroke. Strategies in improving the self-perceived performance of using paretic upper limb, (e.g. incorporate “graded” activity training into customary physical training, and give positive feedback on functionally relevant improvements), could be implemented in order to enhance upper limb motor function after a stroke. Author(s) Disclosures The authors received research support from the Health and Medical Research Fund 12131821 from the Food and Health Bureau, HKSAR.